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A System of Orthopaedic Medicine by L Ombregt, P Bisschop, H J ter Veer, T Van de Velde. W B Saunders, Philadel- phia (British distributor: Harcourt Brace and Co Ltd, Foots Cray High Street, Sidcup, Kent DA 14 5HP), 1995 (ISBN 0 7520 1595 4). Illus. 974 pages. f95.

This large and definitive text has been compiled by four authors - two doctors, and physiotherapists from Belgium and Holland. They have clearly thoroughly researched their subject matter and have produced a very detailed guide to Dr James Cyriax’s theories on the assessment and treatment of neuromusculo- skeletal lesions. The book covers sections on general principles and all the areas of the body treated in orthopaedic medicine with additional sections on entrapment neuropathies and psychogenic pain.

The introduction states clearly that this book is meant to be confined to the Cyriax approach and it therefore includes some of the manipulations and other techniques that he employed. However, many clinicians practising orthopaedic medicine in this country would debate the use of some of the stronger techniques that have been included.

The clear anatomical drawings add to the information in the text and there are many flow charts and tables. Some of these are rather difficult to follow and perhaps might have been more helpful if they were presented in a simpler form.

The extensive reference list includes many articles that are not written in English and this list would have been much improved if it had contained more references to recent research in some areas such as caudal epidural anaesthesia and spinal innervation.

Although the cost of the book may deter some readers it is lavishly produced and an excellent summary of this particular approach t o the diagnosis, assessment and treat- ment of neuromusculoskeletal pain. It would be a useful reference book for physiotherapists working in orthopaedic out-patient and primary care settings.

Stephanie Saunders MCSP

Health and Social Care Management A guide to self development by Sara Whiteley, Richard Ellis and Sinclair Broomfield. Arnold, London, 1996 (ISBN 0 340 6141 10). 220 pages. f 15.99.

‘In order to manage a t all we need to manage ourselves.’

This book is written for managers ‘caught in the sandwich’ of senior managers and shop-floor colleagues, and for established managers striving for greater efficiency.

There are 15 chapters covering the key current topics and skills needed by today’s public sector managers.

Chapters are prefaced by a precis of content - useful if one is ‘dipping’ into the book and not reading it as a whole. Conclusions are succinct, being followed by references and further reading suggestions. Some of the references and further reading suggestions are old but ‘keystone’.

The ‘Introduction’ and ‘Introduc- tion to Managerxent’ chapters 1 and 2 are comprehensive.

Chapters 3 to 14 address the key issues of time management, communication, leadership, staff relations, finance, customer care and quality.

Chapters contains case studies, checklists and suggested activities. Tables and figures complement the text and are clear and concise.

The conclusion is logical and thought-provoking.

This book is extremely easy t o read and should be of use t o all managers, as an introduction for new managers, an interesting text for the self-development of middle managers, and as an aide me‘moire for experienced managers.

Nora Price MCSP

Gua Sha A traditional technique for modern practice by Arya Nielsen. Churchill Livingstone, Edinburgh, 1995 (ISBN 0 443 05181 X). Illus. 169 pages. f25.50.

This is an interesting book which describes a type of massage which is applied to areas of the body and is based on traditional Chinese diagnosis for its application.

The book is presented in seven chapters. The first three give a background to traditional Chinese medicine (TCM) with special refer- ence to the triple energizer.

In chapters 4 and 5 gua sha is

Top: Correct prone position for gua sha to entire dorsal body - back is supported and neck relaxed. Below: Incorrect position - because back is arched, neck is tightened

addressed and the technique of application described. There are ample illustrations of various applications and these show raised reddened areas on the skin, expect- ed to last for several days.

The effect is produced by ‘scraping’ a smooth metal object over the skin. In the text the effect of this technique on connective tissue is described and it appears to be similar to that of connective tissue massage.

The seventh chapter consists of case histories.

The book is well presented and illustrated. At the beginning of each chapter there is a summary list of the contents which is helpful for quick reference.

Gua sha could be a way of applying TCM theory in treatment without using invasive techniques. However, the physical results on the skin could cause problems in clinical practice as regards patient compliance. Although the text is comprehensive, one would hesitate t o use this technique without having attended a course-of instr- uction.

Nadia Ellis MSc MCSP

Physiotherapy, February 1997, vol83, no 2