jagomart
digital resources
picture1_Medical Books Online Free 117009 | Full Item Download 2022-10-05 20-58-13


 165x       Filetype PDF       File size 1.27 MB       Source: www.bmj.com


File: Medical Books Online Free 117009 | Full Item Download 2022-10-05 20-58-13
british medical journal 5 january 1980 35 medicine and books br med j first published as 10 1136 bmj 280 6206 35 on 5 january 1980 downloaded from aquestion ofnutrition ...

icon picture PDF Filetype PDF | Posted on 05 Oct 2022 | 3 years ago
Partial capture of text on file.
           BRITISH MEDICAL JOURNAL         5 JANuARY 1980                                                                                       35
           Medicine and Books                                                                                                                          Br Med J: first published as 10.1136/bmj.280.6206.35 on 5 January 1980. Downloaded from 
           Aquestion ofnutrition
           Inequality in Society Series. "Prevention of Handicap and the         Farmers and their wives, by contrast, have very low mortality
           Health of Women." Margaret Wynn and Arthur Wynn.                      rates from these diseases. The inference is that good nutrition
           (Pp 247; £9 95.) Routledge and Kegan Paul. 1979.                      increases resistance to many diseases, including cancer, and
                                                                                 poor nutrition lowers resistance. Research into what members
           Margaret and Arthur Wynn have travelled widely and dug                of the armed Forces and their wives eat, and then changing it,
           deeply into regional and national statistics from many countries      would be an easy way of testing the hypothesis.
           to try to find out why the perinatal mortality rate and the              The book ends with the Spastics Society's resolution at a
           incidence of handicapped children in the British Isles are so         public meeting last year. It calls upon the Government to
           high. The causes, it turns out, are manifold and the answers          improve services for pregnant women and unborn babies,
           much more complex than recent controversy among paedia-               create first-class maternity units with special and intensive care
           tricians about perinatal facilities in hospitals would suggest.       facilities for the newborn in every health area, finance further
              There seem to be two main problems: babies of low birth            research into the cause and prevention of handicap, and start a
           weight, and babies with malformations of the central nervous          campaign for the health education of women. All laudable
           system such as spina bifida and anencephalus which arise in the       objectives but, on the evidence presented in this book, measures
           first trimester of pregnancy. The latter occur so much more           to improve the nation's diet would seem an immediate priority.
           often in children of Irish mothers that they are thought of as a                                                        ANDREW SMITH
           "curse on the Celts." Popular belief that diseased potatoes
           might be responsible foundered when investigations disclosed
           that white bread with fewer added vitamins than in the rest
           of the UK has supplanted potatoes as the staple food of the           Rights and wrongs for doctors
           lower socioeconomic groups in Eire.
              Emigration to the USA breaks the curse: as soon as the             Decision Making in Medicine: thepractice ofits ethics. Ed Gordon
           Irish take to the indigenous diet there their incidence of brain-     Scorer and Antony Wing. (Pp 211; £6 50.) Arnold. 1979.
           damaged infants falls to normal levels. This suggests dietary
           deficiency as a likely cause. The Wynns cite epidemics of             Perhaps it is the fate of all books on medical ethics that they
           malformed babies during food shortages in other countries.            should be disappointing. Disappointment stems fromexpectation
           The first well-documented one occurred after the siege of             being unfulfilled and hopes being frustrated. But it is unfair to     http://www.bmj.com/
           Paris in 1870. There was another in Boston duringthe depression       expect too much by craving for certainty where none can be had
           of the early 1930s and several in European countries occupied         in the difficult task of deciding what is right and what is wrong
           bythe Germans inthe last war and in German cities immediately         conduct. There is need for a great deal ofthought to be given to
           after it ended. The common factor in all these epidemics was          this. Medical knowledge, skills, and power have so increased
           shortage of food. In Oslo during the German occupation in the         and will increase that the serious questions are how these tools
           1940s the effects of food shortage were counteracted by vitamin       shall be used, and there is even the question of whether some
           supplements. Vitamins were given to 700 pregnant women                of them should be used at all. The science can be taken for
           who then produced exceptionally few low birthweight babies.           granted; the uses of science in medicine, however, are not to be       on 5 October 2022 by guest. Protected by copyright.
           In Zaragossa, a rural province of Spain, poor peasant women           determined within the scientific canon, but outside it in ethics.
           have a lower incidence of brain-damaged children than many            We have emerged from the era of jejune belief that science has
           areas ofthe UK. No need ofvitamin supplements there, because          the capacity to solve all our medical problems. Hence any book
           their traditional diet is rich in them. In Sweden intensive           showing evidence of consideration of acceptable medical
           dietary education, which emphasises the importance of vitamins        behaviour is welcome.
           for the health of future babies, has been part of the school             The book's title and subtitle are somewhat misleading. Many
           curriculum since the war. This is reinforced by the district          of the contributors simply describe the problems arising in all
           midwives whom young women consult about contraceptive                 kinds of medical practice. But often there is no subsequent
           advice. Sweden has the lowest perinatal mortality rate in the         analysis giving reasons why the writer prefers one course of
           world and a very low incidence of handicapped children, which         action to another. This, of course, is extremely difficult to do
           suggests cause and effect.                                            but it would have made the book more valuable. It is about
              The authors, one of whom is a statistician, analysed the           decision-making, so the title says, and it is about practice, for the
           mortality rates of different countries and different socio-                             The reader therefore expects an answer to the
           economic groups in the same countries in considerable detail          subtitle says so.      this author think that I ought to do when
           and they have come up with some surprising correlations. They         question, "What does         in           ?" And he does not get
           include the following. Populations with a high death rate from        faced with ethical problems     medicine     ofthe          rather
           cancer in middle age have more malformed babies. Middle-              it; even so, that may be a general criticism        subject
           aged women in lower socioeconomic groups in Scotland have a           than of this particular book. from the Christian point of view,
           very high death rate from cancer, and a very high proportion of          The contributors all write                 is not stoutly pro-
           their babies are malformed. Members of the British armed              but the fact emerges only gradually and it
           Forces and their wives have the highest mortality rates for           claimed. It is therefore a book of Christian ethics applied to
           cancer, above average rates for diseases of the digestive and         medicine; that needs to be kept in mind in the reading, because
           cardiovascular systems, and high death rates from all causes.         it explains some of the assertions and dogma, with most of
        36                                                                                                        BRITISH MEDICAL JOURNAL               5 JANUARY 1980
        which I personally agree. But unsupported dogma is not good                         Durban one out of every 100 patients on the medical ward
        enough for a sceptical audience who do not share similar beliefs                    suffers from typhoid; it accounts for 1-500 of all paediatric
        and preconceived ideas which are not explicitly argued. A                           admissions. Shouldn't this major communicable disease be
        sermon is not a substitute for ethics as moral science. So this is a                prevented? Amoebiasis, tapeworm, schistosomiasis, ascariasis                             Br Med J: first published as 10.1136/bmj.280.6206.35 on 5 January 1980. Downloaded from 
        restatement ofone moral position, leaving most ofthe others out                     abound. And rheumatic fever flourishes, with a prevalence
        of account or giving them only brief mention. That would not                        rate for heart disease of 6-9 per 1000 in African schoolchildren.
        matter if the dogmatic base were declared unequivocally.                            There is no proper discussion ofthe reasons for such disturbing
        Allowance could then be made for statements such as "reserva-                       statistics,  but in his introduction Adams alludes briefly to
        tion of sexual intercourse until marriage is the key to lasting                     malnutrition, overt and subclinical, and the part this might
        happiness and personal fulfilment"-a tenable view for some,                         play in predisposing to infection.
        but by no means all. contributors feel                                                 This book is not meant to deal comprehensively with tropical
           The editors and                               deeply that there is a             or subtropical medicine. It is essentially a companion, full of
        decline in standards of morality and they want doctors to be                        wise and thought-provoking observation. It is a collection of
        "educated in the knowledge of the former truths which gave                          hints and clues to the causes of disease that should delight any
        wisdom and strength to the medical profession and bred                              epidemiologist. How good of Professor Adams to have passed
        confidence in their patients." But former truths need argument                      on to us the benefits of his experience.
        and support and are no longer self-evident. My major criticism                                                                                  R HOFFENBERG
        of this book is that it does not face the fact and the challenge to
        its basic principles: too often, it asserts rather than debates. Yet
        it is worth reading, for it has a case to make which is in the                      Designed for the Continent
        mainstream ofwestern Christian thought as applied to medicine.
                                                                    PHILIP RHODES           Atlas of Rectoscopy and Colonoscopy. 2nd edn. Peter Otto and
                                                                                            Klaus Ewe. Translated by B Clowdus. (Pp 110; $5390.)
                                                                                            Springer. 1979.
        Disease in Southern Africa                                                          Most surgeons would probably agree with Dr Otto and Dr Ewe
                                                                                            that proctoscopy and sigmoidoscopy are largely self-taught, and
        A Companion to Clinical Medicine in the Tropics and Subtropics.                     would welcome publication of a comprehensive atlas to help
        E B Adams. (Pp 210; £8.) Oxford University Press. 1979.                             those with limited experience recognise characteristic endo-
                                                                                            scopic appearances in patients with colorectal problems. This
        Professor E B (Barry) Adams retired recently from the chair of                      book is written for students, surgeons, dermatologists, gynae-
        medicine in the University ofNatal, and A Companion to Clinical                     cologists, paediatricians, and general practitioners-an ambitious
        Medicine in the Tropics and Subtropics is a distillation of his                     and somewhat unrewarding task in the context of British
        experience of disease in Southern Africa over a period of                           medicine today, but no doubt relevant to the Continental system
        roughly 25 years. Strictly speaking Natal is not tropical, but                      of health care for which the atlas was clearly designed.
        many diseases of central Africa are found there and Professor                          There are three approximately equal parts to the book. The
        Adams has had sufficient personal experience to write with                          first  is devoted to a description of history taking, physical
        authority about most of them. He has also included many                             examination, and endoscopic technique including colonoscopy.
        conditions that are definitely not confined to tropical countries                   There is little here that cannot be found in current textbooks
        which-because of racial (genetic or cultural) and particularly                      of colorectal surgery. In particular, the description of colono-
        socioeconomic       factors-differ       profoundly      in    presentation,        scopy and polypectomy is certainly inadequate for anyone                                 http://www.bmj.com/
        course, and management when they affect Africans.                                   attempting these procedures without previous experience. In
           Some of the difficulties of clinical practice in Natal emerge                    the second part ofthe book the authors describe diseases that are
        from the first chapter on neurological disease: the frequent                        later illustrated in the atlas section and also suggest appropriate
        lack of a proper history; the inappropriateness of our customary                    treatment. This section may be useful for students, but the
        tests of intelligence; our inability to assess dysphasia, dysarthria,               content is inadequate for British surgeons in training and in
        or circumlocution in a foreign unintelligible language; the                         several respects the treatments described do not accord with
        elicitation of plantar responses in patients who wear no shoes                      current practice in Britain. It would be unusual, for instance, to
        and have grossly thickened skin over the soles of the feet.                         find a surgeon (or patient) here who approved of injecting                                on 5 October 2022 by guest. Protected by copyright.
        Patterns of disease also differ: multiple sclerosis is yet to be                    phenol in oil into a haemorrhoid instead of above it and, while
        described in a black African; migraine, lumbar discs, carpal                        there is brief reference to the use of "banding," neither maximal
        tunnel syndromes, and Parkinson's disease rarely affect them.                       anal dilatation nor cryotherapy are mentioned. The text of both
           This variation of disease prevalence and pattern is what I                       these sections clearly betrays its German origin. The use of
        find so intriguing when I contrast Adams's experience in                            curious words (what is a "knot" ?) and a ponderous English
        Natal with British medicine. Such diversity must contain clues                      translation will not appeal to the British reader-even if he is
        to aetiology and pathogenesis. What dictates the relative freedom                   familiar with the notoriously inaccurate terminology ofcolorectal
        from atheroma in blacks, and why are strokes common among                           surgery.                                                   is    far the best
        them but myocardial infarcts rare ? In a population prone to                           Thecolour atlas itselfcompletes the book and              by
        hypertension heart failure is a common sequel, but myocardial                       part of it. Each plate is accompanied by a brief description and
        infarction is not-why? And what is the basis of congestive                          commentary on the lesion illustrated. The colour photographs
        cardiomyopathy, which accounts for a quarter of all heart                           are well chosen, technically satisfactory, and, with the help of
        disease, 9800, of the sufferers being black (African) ? The im-                     the descriptive text, can easily be interpreted-though this
        portance of these observations has obviously not escaped                            would sometimes be easier if the orientation was more clearly
        Adams; in fact, he highlights these differences wherever                            indicated on the illustration. The colonoscopic photography is
        possible and wisely refrains from too much speculation to                           technically less satisfactory but, as the authors have illustrated
        explain them.                                                                       most common higher lesions in their sigmoidoscopic series, this
           Another message emerges from the book-the frequent                               is no great disadvantage. This section, though not comprehen-
        occurrence of diseases that are preventable, that should not                        sive, would interest the trainee surgeon in the United Kingdom
        exist in such a wealthy and up-to-date country. Tetanus still                       and perhaps be of value to those who work in isolated circum-
        takes its toll of neonates, older children, and adults; why has                     stances who are confronted by an unfamiliar colorectal problem.
        no proper immunisation programme been introduced? In                                   It is a pity that the atlas section-which is the most likely one
           BRITISH MEDICAL JOURNAL           5 JANUARY 1980                                                                                              37
           to appeal to the British reader-occupies only 40 of the book's            medicosocial problems of developing countries. Subsequent
           110 pages. As a whole, the book is marred by inaccuracies and             experience in emergency war surgery led him into disaster
           omissions in the text which must reduce its value to surgeons             management and to high office in the medical division of the
           or general practitioners in training in the United Kingdom.                International Committee ofthe Red Cross. Now, in four concise             Br Med J: first published as 10.1136/bmj.280.6206.35 on 5 January 1980. Downloaded from 
           General surgeons and those with a special interest in colorectal           chapters, Dr Spirgi reviews disaster management, disaster
           surgery will enjoy the photographs.                                        planning, training in disaster management, and mass casualty
                                                                   ADAM LEWIS         care. One of the main problems of international disaster relief
                                                                                      is that all too often it is uncoordinated, inappropriate, and,
                                                                                      sadly, usually too late. The mismanagement by donor countries
                                                                                     is often compounded by mismanagement in the affected country.
           Turned and unturned stones                                                 To overcome this problem Dr Spirgi outlines the role of a
                                                                                     national disaster committee which would be responsible for
           Renal Calculus. Leslie N Pyrah. (Pp 370; $49.) Springer. 1979.             predisaster  planning and preparedness (including disaster
                                                                                      prevention). After a disaster this committee would assess the
           Hardlyanissue ofany urological journal goes by without a paper            needs created in terms of medical care, food, clothing, and
           on some aspect of stone disease, perhaps the oldest and still the         shelter, and would be in a position to assess the national
           most perplexing ofall urological problems. This makes it all the          resources, and to call on specific international aid.
           more amazing that one author could cull from published work                  An important aspect of disaster management is to provide
           and from his own vast clinical experience such an extensive and           adequate training in basic life support not only for doctors, but
           succinct account of the present state of affairs.                         for paramedical teams and for the lay public. Following the
              Few of us could quote an experience with over 500 patients             disaster impact, initial casualty management is dependent on the
           with stone followed for a minimum of 10 years and many for                surviving members of the community, who must be familiar
           20 years. Leslie Pyrah, ex-professor of urology in Leeds, can             with the assessment and support of vital functions rather than
           do just this. This is a splendid book that I cannot help but be           the more traditional first-aid measures. Many would endorse Dr
           proud of owning. The contents are arranged in such a way as to            Spirgi's emphasis on the need for compulsory life support
           invoke maximum interest, and there is a short historical note at          training in secondary schools.
           the beginning of many sections. The first chapter on the                     The final chapter on mass casualty management emphasises
           epidemiology of urolithiasis is fascinating because it correlates         the critical importance of triage, and explains that triage is not
           changes in lifestyle and diet with incidence of stones. Mr Pyrah          just the assessment and sorting of the injured according to the
           discusses the classical theories of stone formation-simple                severity of the injuries, but should also be applied according to
           crystallisation, crystallisation on an organic colloidal material, or     the benefit that can be expected from available medical treatment
           the presence of inhibitor substances that stop us all from freely         at the time. Once again, the need for delayed primary closure of
           forming stones. He also reviews all the possible underlying               any missile wound is stated.     Dr Spirgi has encompassed the
           mechanisms, both congenital and acquired, and the biochemical                In this small monograph              and I commend it as an
           factors.  These include such rarities as xanthinuria and                  whole range of disaster planning,         that will be of interest to
           cystinuria.                                                               introduction to disaster management
              Above all, this is a clinical text that tells us just when to          all doctors.                                          P E A SAVAGE
           attempt to pull a stone out of the ureter with a basket and when
           it is safe to leave a small stone in the kidney. I was pleased to see
           that the blood and urine tests for patients with stones are as
           simple today as they were 10 years ago-and, sadly, often about                                                                                       http://www.bmj.com/
           as useless in the vast majority of patients. I, for one, have yet         Super for someone
           to discover a previously undiagnosed patient with cystinuria by
           routinely looking for cystine in the urine. Although there is a           Monographs on Endocrinology. Vol 13. "Vitamin D: Metabolism
           wealth of instruction on how to remove stones, I could not find           and Function." H F DeLuca. (Pp 80; $16.) Springer. 1979.
           any indication of Mr Pyrah's favourite surgical approach to the
           kidney. One ofthe major advances in operative stone removal is            Motoring correspondents in the popular Sunday papers often
           the use within the kidney of a cystoscope, paediatric resecto-            begin their review of the latest offering from Turin or Long-
           scope, or even a specially designed nephroscope. The use ofthese          bridge with a highly improbable but moderately long story                   on 5 October 2022 by guest. Protected by copyright.
           instruments, which is not discussed by Mr Pyrah, has gone a               having only tenuous links with the motor trade. This may be
           long way to make his section on partial nephrectomy for stone             because the only new features ofthe car under consideration are
           redundant.                                                                technical innovations of interest only to, or within the com-
             The urological world owes a debt to this much respected                 prehension of, the enthusiast. To hold the interest ofthe general
           author and would do well to heed his words of wisdom.                     reader is a more difficult task because his demands are more
                                                               RHWHITAKER            prosaic: "Will it hold the wife, kids, dog, and mother-in-law,"
                                                                                     or, light years further down the aspirational scale, "Will it pull
                                                                                     the birds ?" Undeniably, Professor DeLuca's book on vitamin D
                                                                                     has a good deal less sex appeal than the latest Ferrari, but being
           Coping with calamity                                                      £21 200 cheaper is quite an attraction. Even so, the analogy
                                                                                     with the motoring correspondent remains: is it a book for the
                                                       Guidelines                    general reader or the enthusiast ?               one who has been
           Disaster Management: Comprehensive                      for Disaster         It is a beautifully written monograph by
           Relief. Edwin H Spirgi. (Pp 118; Sw frs 34.) Hans Huber. 1979.            concerned with many of the fundamental advances in this
                                                                                     subject. As one would expect, it is an authoritative review but
           One of the fascinations of disaster planning is that it covers            one with a feel for the temporal perspective of the vitamin D
           almost the full range of human activity-from the detailed                 story. This is well illustrated by the first chapter, which sets out
           clinical management ofa few victims after a road accident to the          the historical aspects ofthe growing awareness ofthe nature and
           mass casualties and sociopolitical consequences of major natural          function of the vitamin. I found this fascinating reading, not
           disasters affecting thousands of men, women, and children.                least because of the amazing intellectual ability of the early
             Dr E H Spirgi graduated from Basle and, during his post-                workers such as Mellanby, McCollum, and Steenbock, who,
           graduate work as a general surgeon, became interested in the              with only a rudimentary understanding ofthe nature ofvitamins,
        38                                                                                        BRITISH MEDICAL JOURNAL         5 JANUARY 1980
        were none the less able to construct hypotheses about structure         Together with nine other contributors, she discusses the "gut
        and function which subsequently proved largely correct.                reaction" of neuroimmunology. Dare we believe the presence
          The first third of the book describes the structure of the           of jejunal mucosal antigens to measles in multiple sclerosis, to
        various vitamin D metabolites and reviews the factors exerting         poliovirus in amyotrophic lateral sclerosis, and to herpes virus
        a controlling influence on their production. This is extremely         in progressive muscular atrophy ?                                           Br Med J: first published as 10.1136/bmj.280.6206.35 on 5 January 1980. Downloaded from 
       well done, providing as it does considerable detail while remain-          Whereas Cleave or Burkitt might ponder the use of a holy
       ing intelligible to the non-biochemist. The next section considers      bran to bind and eliminate noxious substances from the intestine,
       the action of vitamin D on the target organs: intestine is dealt        Cook et al actually claim clear evidence of clinical improvement
       with in considerable detail but the sections on bone, kidney, and       in motor function, speech, skilled acts, and the abolition of
       muscle are rather brief-perhaps reflecting the extent of our            fasciculation in amyotrophic lateral sclerosis from the use of
       ignorance in these areas. Although the references are com-              antiviral agents capable of removing antigen from the jejunal
       prehensive and up to date I came away from this section with a          mucosa. In a chapter devoted to myasthenia gravis, much play
       feeling that more could have been made of it by providing an            is made ofthe fact that a single electroplax cell from the electric
       overview of the problems facing investigators. Thus much of             organ of the eel, Electrophorus electricus, contains some 2 x 1011
       the work on renal actions of vitamin D is dismissed on technical        nicotinic acetylcholine endplate receptors similar to those of the
       grounds, and yet there is an opportunity here to put this in some       skeletal muscle of less startling individuals. It is also suggested
       sort ofperspective so that the interested reader is better informed     that the antigenicity of the ionophore protein may be as
       should he wish to go back to the source material. A minor               important in the aetiology of myasthenia as that of the endplate
       criticism is that a review of the interrelationships in the calcium     receptor.
       homoeostatic system precedes this section on target organ                  A social reviewer was once sued for writing, "I have already
       function rather than being placed in a later co-ordinating role.        described Lady So-and-So's dress." Do I describe the im-
          The final section dealing with the clinical use of vitamin D         peccable quality of the photomicrographs, the excellent tables,
       and its metabolites consists of only two and a half pages and           clear prose, and thought-provoking text ? A minus factor is the
        can do little more than draw attention to the diseases with which      careless compilation ofthe names and initials ofthe contributors.
        an abnormality of vitamin D has been implicated. Perhaps it is         Even so, each chapter contains some worthwhile comment.
        the brevity of this last chapter that highlights the dilemma of        Not all the work has been reproduced in other centres. Thus
       this book and brings us back to the motoring metaphor: at               Pertschuk et al in an honest discussion on viral antigens of the
        whomis the book aimed ? As a text for the undergraduate in his         jejunal mucosa emphasise that difficulties in tissue handling
        physiology and biochemistry courses it is superb, if, that is, he      have meant that some of their exciting results as yet lack
       needed such a comprehensive understanding of vitamin D                  confirmation by other workers. In this regard, the emphasis
        structure and function. For those clinicians wishing to develop        laid on detailing the experimental techniques throughout the
       an interest in metabolic bone disease it is an ideal introduction       volume is a welcome departure from the all-too-brief discussion
       to the basic physiology, but I wonder how many will be un-              more usually available. Progress in Neurological Research is not
       familiar with this data and would they not be better served with        designed for the student, but for the interested scientific
       something more clinically orientated ? For those already working        graduate this is a satisfying yet speculative volume on the ever
       in the specialty much ofthe data will be well known but the size        developing subject of clinical neuroimmunology.
       and nature of this monograph precludes an in-depth critique
       of some of the more contentious topics.                                                                                E M R CRITCHLEY
          I thought that this was a super little book but I just wish I
       knew for whom it was intended.                                          References
                                                       DAVID J HOSKING
                                                                                 Clinical Neuroimmunology, ed P 0 Behan and S Currie. Volume 8 in the      http://www.bmj.com/
                                                                                   series Major Problems in Neurology. London. Saunders, 1978.
                                                                                2 Clinical Neuroimmunology. Ed F Clifford Rose. London, Blackwell, 1979.
       The continuing debate
       Progress in Neurological Research: with particular Reference to            Contributors
       Motor Neurone Disease. Ed Peter 0 Behan and F Clifford Rose.
       (Pp 232; £16.) Pitman Medical. 1979.                                          ANDREW SMITH is a general practitioner and a lecturer                  on 5 October 2022 by guest. Protected by copyright.
       This is the third book by Behan-Rose Productions on Clinical               in family medicine at the University of Newcastle upon
       Neuroimmunology. On this occasion the title is different' 2 but            Tyne.
       there is a similar panoramic sweep of lymphocytic behaviour,                  PHILIP RHODES is postgraduate dean of medicine at the
       myelin    disruption,  persisting   viral  infections,  serological        University of Newcastle upon Tyne.
       changes, clinical considerations, and experimental models before              R HOFFENBERG is Professor of medicine at the Uni-
       zooming in on the principal theme of motor neurone disease.                versity of Birmingham.
       The presentation, alas, is not entirely free from camera wobble.
          For a resurrected Bernard Shaw, Progress in Neurological                  ADAM LEWIS is a consultant surgeon at the Royal Free
       Research would provide a most fruitful source from which to                Hospital, London.
       update his satire on Almroth Wright's immunology as depicted                  R H WHITAKER is a consultant urologist at Adden-
       in The Doctor's Deilemma. Beneath the cloak of scientific                  brooke's Hospital, Cambridge.
       respectability, the most exciting and fantastic hypotheses are
       garishly displayed. Thus the book begins with the postulate                  P E A SAVAGE is a consultant surgeon at Queen Mary's
       thatthepresenceofevanescentsubstrates-T (andB)lymphocyte                   Hospital, Sidcup, Kent.
       interaction modulation factors-with a half-life measured in
       nano-seconds and neutrino-like properties, can divert lympho-                DAVID J HOSKING is asenior lecturer and honorary con-
       cytes from their Calvanistic predestination to selected sites              sultant physician at University Hospital, Nottingham.
       into alien tissues where they can cause autoimmune reactions.                EMRCRITCHLEYis a consultant neurologist at Preston
       ThenameofDrFlorenceNidzgorski, unit director, Department                   Royal Infirmary.
       of Neuroscience, the Long Island College Hospital, Brooklyn,
       New York surely conjures forth an ideal Shavian heroine.
The words contained in this file might help you see if this file matches what you are looking for:

...British medical journal january medicine and books br med j first published as bmj on downloaded from aquestion ofnutrition inequality in society series prevention of handicap the farmers their wives by contrast have very low mortality health women margaret wynn arthur rates these diseases inference is that good nutrition pp routledge kegan paul increases resistance to many including cancer poor lowers research into what members travelled widely dug armed forces eat then changing it deeply regional national statistics countries would be an easy way testing hypothesis try find out why perinatal rate book ends with spastics s resolution at a incidence handicapped children isles are so public meeting last year calls upon government high causes turns manifold answers improve services for pregnant unborn babies much more complex than recent controversy among paedia create class maternity units special intensive care tricians about facilities hospitals suggest newborn every area finance furt...

no reviews yet
Please Login to review.