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Obstetrics Illustrated by Alistair W F Miller and Kevin P Hanretty. Churchill Livingstone, Edin- burgh, 1997 (ISBN 0 443 05041 4). Illus. 42 pages. f25.

The fifth edition of this already popular book, as its title suggess, illustrates all aspects of obstetrics. Introductory chapters cover anat- omy, physiology and diagnosis of pregnancy. They progress in a logical and clear order to ante-natal care which includes normal and abnormal pregnancy, labour and the puerperium. Concluding chapters cover the newborn, discussing aspects such as idio- pathic respiratory distress syn- drome and congenital defects. Finally, contraception is reviewed.

In general, the text is easy to read and so would suit all levels of experience. The content of the book

has been updated to reflect recent developments in obstetrics.

In terms of layout, clear illus- trations accompany the text and these have also been updated in comparison t o earlier editions. However, detailed illustrations of how to perform a Caesarian birth or forceps delivery may appear to be more appropriate for medical staff, but are nonetheless very informative.

Criticisms of the book are few. Other than a small number of Government statistics, data re- garding current management are scarce. This is highlighted by a generalised statement in the book that ‘many’ hospitals offer exercises-to-music classes following the post-natal check. I have not found this to be the case.

There are brief sections on

physiotherapy practice in both ante- and post-natal care, but not in enough depth t o be used as a teaching aid for physiotherapists. However, it is good to see a medical text promoting the importance of physiotherapy in obstetrics, and acknowledgements are made to Dorothy Sorley who has contrib- uted to these sections of the text.

I would recommend this book to all physiotherapists working in obstetrics. I t is clear, concise and covers a wide variety of aspects in this area. Overall it is an excellent reference text.

The new edition may be too expensive for individual purchase, but it would be a valuable up-to- date addition to any physiotherapy department library.

Ann Pearson MCSP

Caring for the Fourth Age A practical guide to medical problems in old age by Dr J J Oram. Published by Armelle Press, 1997. Available from Mrs M Bennett, St George‘s Hospital Medical School, London SW17 ORE. Illus. 223 pages. Hardback f 16plus f3.50postage, paperback f7.50 plus f2.50 postage.

This thoroughly readable book covers a wide variety of topics and would be a value-for-money purchase for professionals, carers and students alike working with elderly people.

It is not the author’s intention in this publication to give detailed pathology but instead t o give practical guidelines on how t o deal with commonly encountered medical problems. This is parti- cularly emphasised by the use of case studies.

The initial chapter covers the

‘demographic tidal wave’ illus- trating the expected growth in the elderly population over the coming years. I t is followed by a section dealing with the characteristics of illness in old age, where typically a series of symptoms rather than a specific disease process is identified. For example, an eld- erly person who is confused and falling may have a multitude of medical conditions but is perhaps seen as a social problem and as such is not necessarily appro- priately diagnosed.

The book continues by using several chapters to look at the more commonly encountered conditions including stroke and Parkinson’s disease, heart and lung disease, osteoporosis and arthritis among others.

Rehabilitation and therapy are also covered in detail. Three phases

‘Where you can see an area of reddened or broken skin the damage is likely to be much more extensive in the deeper areas of fat and muscle’

of management are recommended to be carried out when an elderly person is admitted to hospital: 1. The acute diagnostic phase in which the correct diagnosis or diagnoses are made, and given the appropriate treatment. 2. The rehabilitation phase, in which the patient can reach maximum potential. 3. The discharge phase, or return to home, with adequate support and awareness of the home environment.

Little mention is however made of the work of community therap- ists who play a vital role in continuing the rehabilitation process after discharge from hospital.

Social issues are dealt with, including social services, long-term care, benefits, death, bereavement, ethics and carers. These are dealt with in a sensitive way with illustrations by case studies.

Real assessment of how much a reader has taken in can be ascertained by completing the ‘Quiz on Ageing’ in the final chapter. I felt that it was easy to absorb information as the book is written in such a readable manner, and consequently would have no hesitation in recommending it t o others.

Pamela Anderson MCSP

Physiotherapy, May 1998, vol84, no 5