162
BOOK
RHEUMATOID
9k x 5
London
By
ARTHRITIS.
in. Pp.
: Oxford
Charles
REVIEWS
L. SHORT,
x +480,
with numerous
figures
University
Press.
Price
55s.
and
tables.
Walter
BAUER
Index.
and
1957.
William
Harvard
E.
REYNOLDS.
: University
Press.
The
nature
of rheumatoid
arthritis
is very complex
and its etiology
is still unknown.
Numerous
based
upon
large series
of cases
have been carried
out before,
a notable
one in Great
Britain
being
that of Fletcher
and Lewis-Faning
in 1945.
The latter
writer
also carried
out a study
matching
patients
with controls
in a considerable
investigation
sponsored
by the Empire
Rheumatism
Council
in 1950.
The present
study
is an altogether
admirable
development
of this statistical
approach.
It is
divided
into forty-five
chapters.
The first, giving
a review
of previous
work,
is followed
by a discussion
of the diagnostic
criteria
for the selection
of patients.
The series used was drawn
from 300 consecutive
patients
admitted
to the medical
wards
of the Massachusetts
General
Hospital
between
1930 and 1936
and in whom
the diagnosis
of rheumatoid
arthritis
was supported
by extensive
clinical
and laboratory
study.
The
differentiation
of rheumatoid
arthritis
from
other
forms
of chronic
joint
disease
is
studies
beautifully
investigation
presented.
The remaining
such as sex distribution
five-sixths
of the
volume
deals
with
the various
sections
of
; age of onset ; family
history
; allergic
diseases
; occupation;
the menopause
; precipitating
factors
; joints
first involved
; constitutional,
vasomotor,
neurologic
and
gastro-intestinal
factors
; lymph
nodes ; the skin ; nodules;
joint
examinations
; foci of infection
and
the pathological
investigations,
etc.
The final chapter
is a careful
summary
of the results.
Each
chapter
also is provided
with a concise
summary
and includes
a brief
list of objectives
for further
study.
It is not possible
to select elements
of this review
for special
comment
: every chapter
contains
material
rich in value
and, although
strung
upon
great
detail,
is presented
in a thoughtful
and most
readable
style.
Of some
interest
is the literary
and typographic
presentation.
Each
paragraph
is
numbered
in reference
to the chapter
number,
e.g., the eighth
paragraph
of the forty-second
chapter,
which
is on Spondylitis,
deals
with “ objectives
for further
study
“
and is preceded
by the bold 42.8
which
makes
for easy reference
and indexing.
Incidentally
this paragraph
includes
a question
“
whether
or not rheumatoid
spondylitis
constitutes
a distinct
disease
entity
“
; the answer
reflects
the general
American
tendency
to regard
it as not so, yet maintains
an open
mind.
This volume
is produced
under
the auspices
of the Commonwealth
Fund
(of Massachusetts).
Amongst
the supporters
of the
researchers
who are acknowledged
by the authors,
it is pleasant
to see the name
of one of the pioneers
of modern
American
orthopaedics
in the “ Robert
W. Lovett
Memorial
Foundation
“
(established
by
Dr Frank
Ober).
One cannot
speak
too highly
of this most
instructive,
well written
and excellently
produced
work.-Norman
ORTHOPEDIC
Jun.,
B.A.,
Orthopedic
Pp. xii+508,
CAPENER.
SURGERY
IN
INFANCY
M.D.,
Silver
Associate
Professor
Service,
University
of Pittsburg
with 504 figures.
Index.
1957.
AND
CHILDHOOD.
By Albert
Barnett
FERGUSON,
Orthopedic
Surgery,
University
of Pittsburg;
Chief
of
Medical
Center;
with four collaborators.
10 x 7 in.
London:
Bailli#{232}re, Tindall
and Cox.
Price #{163}6.
The orthopaedic
surgeon
who would
search
for guidance
in the management
of one of those
conditions
from
which
his title derives
must too often
feel the temper
of his enthusiasm
failing
as he
searches
journal
and text for a reasoned
and brief account
of the source
of his interest.
The author
ofthis
book recognises
this paradox
in his preface
and with the aid offour
distinguished
contributors
sets himself
the task of making
good
this deficiency
in the literature
of our speciality.
The book,
which
is largely
written
by Ferguson
himself,
goes a long way towards
fulfilling
this aim.
The opinions
expressed
and the practice
advocated
rarely
differ
from
those
customary
in the United
Kingdom.
There
are differences,
of course,
and some,
usually
minor
and involving
degrees
of emphasis
rather
than
matters
of principle,
will be mentioned
in this review.
The illustrations
are admirable,
and not only clarify
but amplify
the text, which
seldom
lapses
from
either
literacy
(“
institutionalisation
“)
or accuracy
(“ Dennis
Browne
“).
The bibliography,
brief
and well chosen,
provides
an
introduction
to further
reading
when considerations
of space
or balance
have curtailed
discussion.
The first two chapters
deal with disorders
of the foot and knee in an orthodox
manner.
Many
surgeons,
however,
might
hesitate
to forbid
weight
bearing
in K#{246}hler’s disease
until the bone density
is repaired.
The regional
approach
continues
with a chapter
on diseases
of the hip joint
in which
the treatment
of congenital
disorders
is discussed
with
admirable
clarity
and
conviction.
Less
conviction
is shown,
perhaps
justifiably,
when
the
management
of
Legg-Perthes’
disease
is considered.
The reader
is urged
to drain
suppurative
arthritis
of the infant’s
hip as soon as the diagnosis
is madea recommendation
that will be supported
by many
British
surgeons.
The decline
of Pott’s
disease
is
rightly
reflected
by the comparative
brevity
of the section
devoted
to it. Late spinal
fusion
is advocated
in all cases,
but the possibility
of direct
surgical
attack
on the vertebral
bodies
with drainage
is not
THE
JOURNAL
OF BONE
AND
JOINT
SURGERY