122

is that congenital heart disease and colour flow map- ping is not as well covered as it should have been.

I was very impressed by this book. It is not compre- hensive enough to be suitable as a reference book, but even the most experienced echocardiographer, techni- cian or physician, will learn from it. It is a must for all the departmental libraries, but with 315 pages of read- able text and well produced Doppler examples and at E30 cost, it is a bargain well worth having as a personal

COPY.

Guy’s Hospital Shakeel A. Qureshi London, U.K. Consultant Paediatric Cardiologist

Clinical Skills in Medicine, 6th ed. Alan E. Read Butterworths & Co, Ltd., London/ Boston/

Singapore, 1989; 252 pp.; E6.95 (paperback); ISBN O-7236-1163-7

This small book is the direct successor to “The Clinical Apprentice” by John Naish, first published in 1948 and which ran to five subsequent editions. It is specifically aimed at medical students entering clinical medicine for the first time. It includes examination techniques for each of the major body systems together with special sections for the patient in coma and the elderly. In addition approximately one-third of the book is given over to brief descriptions of commonly used investiga- tive techniques.

Its virtues include its size (it will easily fit into the pocket of a white coat), brevity and clarity. Moreover, it is not written without humour. Diagrams are much in evidence throughout, and the tables and lists included are not too intimidating. The only minor criticism, apart from irritating typographical errors, would be that pathophysiological explanations of some physical signs are necessarily limited by the size of the book but, on occasion, may be too empirical.

Overall “Clinical Skills in Medicine” probably suc- ceeds in its attempt to be a rapid and easily assimilable guide to history taking and clinical examination for the medical student. It would make a good vademecum in the early stages, a task made easy by its size and weight. Its main competition in the U.K. are “Clinical Ex- amination” (edited by MacCleod and Munro) and “Hutchinson’s Clinical Methods” (edited by Swash and Mason). Undoubtedly students should possess a book on clinical examination but the choice between the three is probably individual.

Dept. of Cardiology Brompton Hospital London. U.K. John Hogan

Don’t Eat Your Heart Out Joseph C. Piscatella Thorsons Publishers Ltd., Wellingborough, 1989; 305 pp.; E5.99 (paperback); ISBN O-7225-1717-3

A popular book on the evergreen subject of diet and coronary disease, giving a patient’s eye view, as the author underwent bypass surgery himself. Its best fea- ture is its bright, eye-catching title; otherwise the mes- sage is the same as received by coronary patients all over the world in the last 50 years: to reduce their intake of cholesterol, saturated fats, salts and sugar, and increase that of fruit, vegetable and fibre. The recom- mended fare is called “positive diet”! How that differs from “prudent diet”, is difficult to say.

While the book is well written, it contains some annoying scientific baby-language. Is it really necessary for any public to refer to high-density lipoprotein as “good” cholesterol, low-density lipoprotein as “bad” cholesterol, venous blood as poor blood, oxygenated blood as rich blood? Also there seems to be some confusion about monosaccharides, like glucose and fructose, which are regarded as natural sugars, while the disaccharide sucrose is apparently the devil’s invention. In view of the fact that the digestive system wastes little time in breaking down sucrose to its constituents, glu- cose and fructose, wouldn’t it be better to say that the basic trouble with sugar is that it is an addictant? We tend to consume far too much of it and the excess does not do us any good, no matter what kind of sugar we eat.

The book contains one welcome example to demon- strate that ideas originating later than the first half of this century are beginning to percolate into public awareness, The author mentions the fact that milk does not only contain saturated fats, but also more calcium than needed by adults. But then why does he recom- mend that the milk we buy should be reinforced with vitamin D? To ensure that the excess calcium finds its way without fail to the tissues that do not need them? And what is the advantage of an egg-substitute, consist- ing of egg-white and milk powder over a plain egg?

Department of Cardiology University of Manchester Manchester, U.K. Stephen Seely