1019 The
Reviews of Books
Development of Anæsthetic Apparatus K. BRYN THOMAS, F.F.A.R.C.S., Royal Berkshire 1975. Pp. 268. £12.
Hospital, Read-
ing. Oxford: Blackwell. Mental Handicap GoRDON DUTTON, F.R.C.PSYCH., South Ockendon don : Butterworths. 1975. Pp. 176. /;6.
Hospitals.
Lon-
THIS book is one of the Postgraduate Psychiatry Series under the general editorship of Prof. Linford Rees. Dr Dutton emphasises that mental handicap is a fascinating study in human biology, and in eight chapters, each ending with a list of useful references, the subject is treated from the scientific standpoint with particular reference to causation and remedial therapy. The first chapter, after a brief historical introduction, goes on to consider definition ("A mentally handicapped person is one who does not grow up to meet the average standards"), normal development, intelligence, the distribution of intelligence quotients, incidence and prevalence of mental handicap, and the inheritance of intelligence. The second chapter covers the aetiology of mental handicap under "nonpathological" and "pathological" headings. The third and fourth chapters, on preconceptual causes of mental handicap describe, respectively, chromosomal anomalies, including indications for chromosome studies, and dominant, recessive, and sex-linked disorders associated with mental handicap. There is a brief note on genetic counselling. Prenatal causes of mental handicap associated with malformations are described in chapter 5. Next Dr Dutton deals with natal and postnatal causes of mental handicap, including birth injury, malnutrition, infections, heavy-metal poisoning, and brain damage. The last two chapters discuss the needs of the mentally handicapped, physical, psychological, and emotional, and the residential services for the mentally handicapped, and there is a helpful section on the treatment of patients with violent or antisocial behaviour. Not all conditions associated with mental retardation can be mentioned in a small volume. This work presents clearly, comprehensively, and concisely an up-to-date account of that distinct body of knowledge which mental handicap comprises. It incorporates some plates showing some of the typical conditions, and there are some helpful tables and summaries. It should become an essential reference book for doctors, psychologists, social workers, and nurses.
THOSE who have been eagerly looking forward to the publication of this book will not be disappointed. This book is the most successful outcome of a request by the Association of Anæsthetists of Great Britain and Ireland that the inventory of the Charles King collection of early anaesthetic apparatus should be amplified. Dr Thomas, curator of the collection, has detailed those items for which he is responsible and compared them with specimens in other collections, in Britain and other countries, which have played an important role in the development of anaesthetic apparatus. The book is well illustrated and, for a prestige production, modestly priced. There are many interesting historical snippets about the evolution of anaesthesia as a discipline, and the text is on the whole light and enjoyable to read. The foreword by Professor Rendell-Baker is in itself an admirable resume of the relative contributions of American and British pioneers to the theory and practice of anaesthesia. Practical Geriatrics Edited by H. P. VAN HAHN. Basle: Karger. Chichester: Wiley. White Plains, N.Y.: Phiebig. 1975. Pp. 445. Sw. fr. 63;$25.25;
£12.60 (approx.). THIS geriatric textbook is very largely devoted to clinical problems, although there is a contribution on the general care of the aged and chronically ill. The 21 contributions come from Europe, North America, and Japan. The English is generally excellent, considering that for so many of the authors English is not the language of choice. The book provides many original references, but adopts the unsatisfactory habit of citing many other authorities without giving any reference to their work. British readers will be fascinated to see how geriatric problems are tackled outside the Welfare State. Rehabilitation aspects are dealt with inadequately, considering the vital role they play in geriatrics. Limb contractures are not discussed, and pressure sores are barely touched upon. The haematological chapter is not good; the gastroenterological one is stimulating, but post-gastrectomy malnutrition as an entity is not discussed. Some surgical aspects in the care of the elderly are well dealt with in a medical setting, and the chapters on otorhinology and ophthalmology are good and interesting.
excellent contribution on diabetes mellitus and a the menopause and postmenopausal condifascinating tions (subjects not dealt with in previous geriatric textbooks). The scientific basis of geriatric practice is emphasised throughout (e.g., the irrational use of vasodilators and vitamins is discussed and subsequently deprecated). With its multiple authorship and multinational origin, the book does not claim to be a systematic textbook. However, with its English, French, and German editors it will be a useful reference work, especially for doctors throughout Europe in whose daily clinical work geriatric medicine plays such a large part.
There is
an
one on
Cobalamin, Biochemistry and Pathophysiology Edited
by BERNARD M. BABIOR, M.D., New England Medical Hospital. New York and Chichester: Wiley. 1975. Pp. 477.$25; £13.
Center
VERY few books have been written about vitamin B,2, and of them were published many years ago. Fortunately Dr Babior has now provided clinicians and basic scientists with an up-to-date review about the cobalamins (vitamin-B12 compounds). The first few chapters are devoted to their chemistry, biosynthesis, and coenzyme functions. Most of this section deals with the details of bacterial systems and will be mainly read by biochemists. The second part of the book is devoted to pathophysiology and will be of most interest to clinicians and hsmatotogists. The opening chapter by Ellenbogen contains a good account of intrinsic factor and the transcobalamins. The next chapter, by Linnell, describes his recent studies on the distribution of the cobalamins in normal subjects and in patients with hxmatological or neurological disorders. He also gives an interesting account of a new inborn error of vitamin-B12 metabolism. Mahoney and Rosenberg then summarise the other metabolic errors and Donaldson deals with the mechanisms of malabsorption of vitamin B12. The final chapter, by Beck, takes a critical look at the metabolic features of vitamin-Bl2 deficiency and challenges many of the current explanations for the megaloblastic ana:mia. This book is essential reading for all ha!matologists and for anyone else interested in vitamin B12. most
Stroke and its Rehabilitation Edited by SIDNEY LicHT, M.D., New Haven, Connecticut: Elizabeth Licht. London: Lloyd-Luke. 1975. Pp. 504.$20; £11.
THIS is an excellent American textbook by fifteen contributors, the editor himself contributing three clear, concise, and informative chapters. The chapter on the history of stroke shows how a large number of historical facts can be presented concisely and in a way that sustains the reader’s interest. Dr Licht deals in detail with the stroke rehabilitation programme, drawing on his day-to-day clinical experience, and contributions on physical therapy, neurophysiological therapy, and speech disorders follow on naturally. The chapter on occupational therapy, written by a physician, could be used as a model for planning an occupational-therapy programme in a stroke unit. Much use is made of illustrations from the British
1020
publication Help Yourselves, but many references are incomplete. The section on wheelchairs may be of less value to readers outside the United States but it still gives a clear indication of some of the pitfalls in requesting wheelchairs. The contribution on nursing maintains the high standard and gives a detailed account of the management of stroke patients at all stages of their illness. The earlier chapters deal with the natural history, pathology, pharmacology, and surgical management of strokes; though excellent in themselves, they contain a certain amount of repetition which the editor should have prevented. The chapter on pathology devotes an undue amount of space to angiomas, and the view of hypertension related to stroke is hardly in line with current medical thought. However, the book and illness. text
as a
can
handbook
be recommended both as an academic the everyday management of stroke
on
Index of Suspicion in Treatable Diseases
MANY physicians have something of a surgeon’s spirit within them in their quest for treatable disease. It is right to emphasise treatable diseases in teaching and in practice, but whether or not a disease is treatable is a poor path to fuller understanding and inadequate as a basis for classification. Thus this book-written for a rather unrealistically wide audience of innurses, paramedical personnel, specialists seeking knowledge outside their own specialty-may confuse by its arbitrary ordering and mislead by its dogmatic brevity. The early sections on abdominal and gastrointestinal disease, for example, are, successively, achalasia, hiatus hernia, hypertrophic pyloric stenosis, Zollinger-Ellison syndrome, peptic ulcer, and chronic active liver disease; several more sections follow before the eminently treatable condition of acute appendicitis is reached. If treatment be the source of inspiration, phaeochromocytoma might well have headed the hypertension chapter; but it appears fourteenth in a list opened by high arterial pressure ("big pulse") and high systolic pressure (arteriosclerotic hypertension). Later in the same chapter hypertension due to non-urxmic pyelonephritis (unhelpfully subtitled Butler-Longcope effect) is discussed in the light of two 1937 references. As an instant guide to treatable disease or suspicion of it, this compendium, though elegantly produced, is unsatisfactory.
ternists, general practitioners, and
Famine and Human Development The Dutch Hunger Winter of 1944-1945. ZENA STEIN, MERVYN SUSSER, GERHART SAENGER, and FRANCIS MAROLLA, Columbia University and New York State Department of Mental Hygiene.
University
Press. 1975.
Progress in Neurological Surgery Vol. VI. Edited by H. KRAYENBUHL, P. E. MASPES, and W. H. SWEET. Basle: Karger. White Plains, N.Y.: Phiebig. Chichester: Wiley. 1975. Pp. 489. Sw. fr. 160;$66.75; k23.30
THE sixth volume of this important series concentrates on neurosurgery of the pituitary. The editors are to be congratulated on getting together an authoritative panel of authors who can write clearly and informatively about their experience and technique. The first chapter, on clinical physiology and pituitary tumours, is a most useful summary of pituitary-function tests. The basic pathology of pituitary tumours is reviewed, and there is an additional and interesting chapter on the elec-
microscopy of these tumours. However, the chapters on technique are the most important, and this volume gives the experience of experts in different approaches to the pituitary, including transsphenoidal and stereotactic surgery. Two interesting chapters on heavy-particle irradiation and Bragg peak proton hypophysectomy will be of particular interest as more proton beams become available. The final two chapters from Zurich on chordomas and chondromas give that centre’s wide experience with both lesions. The literature reviews are excellent, but in view of the reputation of the Zurich microsurgical techniques it is disappointing to find no illustrations on this aspect. The whole book is an excellent review of thought and practice, and is strongly recommended. tron
Edited by ORVILLE HORWITZ, M.D., and JOSEPH H. MAGEE, M.D., University of Pennsylvania School of Medicine. Philadelphia: Lea & Febiger. London: Kimpton. 1975. Pp. 574.$29.50; /:14.75.
New York and London: Oxford
ditions but that the reserve is sufficient for function to be unaltered. This hypothesis accords with experimental work, but is even more difficult to test than the original one.
Pp.
284.
$12.95 (hardback), 4.50 (paperback). IT is going to be very difficult to test prospectively in man the hypothesis, drawn from animal experiments, that later mental developmental is adversely affected by nutritional deprivation in utero. Dr Susser and his colleagues are making an attempt, by giving measured food supplements to pregnant women from a population with under-average nutrition, but their completed study is retrospective-and the results were negative. A check on the mental competence of young Dutchmen of military-service age who had been born after the disastrous winter famine of 1944-45 revealed no relation between prenatal nutrition and mental competence. The results, together with other variables studied, have been published previously, but it is useful to have the whole inquiry gathered in one place. If mental performance is affected only by more severe undernutrition than the Dutch experienced that wartime winter a generation ago, then a worse-off population would have more conspicuous problems than depressed mental competence. The Columbia University team thinks that the most likely explanation for its negative finding is the possibility that brain cells really are depleted under these con-
A Manual for Medical Assistants and other Rural Health Workers BO BALLDIN, RICHARD HART, ROLF HUENGES, and ZIER VERSLUYS, Kilimanjaro Christian Medical Centre. Obtainable from African Medical & Research Foundation, P.O. Box 30125, Nairobi, Kenya. 1975. EA Sh 10. The Training of Auxiliaries in Health Care KATHERINE ELLIOTT. Obtainable from Intermediate Technology Publications, 9 King Street, London WC2E 8HN. 1975. Pp 110.
;1.50. THE 28th World Health Assembly in Geneva placed a new on the development of primary health care in the drive towards the promotion of national health services. In many countries success in primary health care will depend on a massive programme of training of auxiliaries and part-time health workers, as in Tanzania. Training-centres need suitably written textbooks, and Dr Elliott’s excellent annotated bibliography of the material specifically written for the training of auxiliaries shows that few such books have appeared-though, as her guide also shows, many centres have been set up. The African Medical and Research Foundation is attempting to fill this gap, and the useful book on child health by Dr Balldin and his colleagues is the first of its publications. Problems arise when doctors try to write for medical assistants. Maurice King in his Nutrition for Developing Countries (1972) made perhaps the first attempt to write a book in simple English, with plenty of illustrations and a limited vocabulary. In the book from Kilimanjaro some attempt has been made to simplify the English, but the vocabulary is still extensive. The book contains several illustrations, but for the readership aimed at an illustration every two pages is needed; Dr Balldin’s group has not provided so many, nor are the ones included wholly suitable for the printing method used. The usefulness of the book will depend on the level of auxiliary available. However, the authors have covered child health reasonably well, and this book should make a real contribution to the training of the many thousands of auxiliaries who will be needed if childhealth services are to be made available to the widespread populations in rural areas such as East Africa.
emphasis
Reviews of Books
Development of Anæsthetic Apparatus K. BRYN THOMAS, F.F.A.R.C.S., Royal Berkshire 1975. Pp. 268. £12.
Hospital, Read-
ing. Oxford: Blackwell. Mental Handicap GoRDON DUTTON, F.R.C.PSYCH., South Ockendon don : Butterworths. 1975. Pp. 176. /;6.
Hospitals.
Lon-
THIS book is one of the Postgraduate Psychiatry Series under the general editorship of Prof. Linford Rees. Dr Dutton emphasises that mental handicap is a fascinating study in human biology, and in eight chapters, each ending with a list of useful references, the subject is treated from the scientific standpoint with particular reference to causation and remedial therapy. The first chapter, after a brief historical introduction, goes on to consider definition ("A mentally handicapped person is one who does not grow up to meet the average standards"), normal development, intelligence, the distribution of intelligence quotients, incidence and prevalence of mental handicap, and the inheritance of intelligence. The second chapter covers the aetiology of mental handicap under "nonpathological" and "pathological" headings. The third and fourth chapters, on preconceptual causes of mental handicap describe, respectively, chromosomal anomalies, including indications for chromosome studies, and dominant, recessive, and sex-linked disorders associated with mental handicap. There is a brief note on genetic counselling. Prenatal causes of mental handicap associated with malformations are described in chapter 5. Next Dr Dutton deals with natal and postnatal causes of mental handicap, including birth injury, malnutrition, infections, heavy-metal poisoning, and brain damage. The last two chapters discuss the needs of the mentally handicapped, physical, psychological, and emotional, and the residential services for the mentally handicapped, and there is a helpful section on the treatment of patients with violent or antisocial behaviour. Not all conditions associated with mental retardation can be mentioned in a small volume. This work presents clearly, comprehensively, and concisely an up-to-date account of that distinct body of knowledge which mental handicap comprises. It incorporates some plates showing some of the typical conditions, and there are some helpful tables and summaries. It should become an essential reference book for doctors, psychologists, social workers, and nurses.
THOSE who have been eagerly looking forward to the publication of this book will not be disappointed. This book is the most successful outcome of a request by the Association of Anæsthetists of Great Britain and Ireland that the inventory of the Charles King collection of early anaesthetic apparatus should be amplified. Dr Thomas, curator of the collection, has detailed those items for which he is responsible and compared them with specimens in other collections, in Britain and other countries, which have played an important role in the development of anaesthetic apparatus. The book is well illustrated and, for a prestige production, modestly priced. There are many interesting historical snippets about the evolution of anaesthesia as a discipline, and the text is on the whole light and enjoyable to read. The foreword by Professor Rendell-Baker is in itself an admirable resume of the relative contributions of American and British pioneers to the theory and practice of anaesthesia. Practical Geriatrics Edited by H. P. VAN HAHN. Basle: Karger. Chichester: Wiley. White Plains, N.Y.: Phiebig. 1975. Pp. 445. Sw. fr. 63;$25.25;
£12.60 (approx.). THIS geriatric textbook is very largely devoted to clinical problems, although there is a contribution on the general care of the aged and chronically ill. The 21 contributions come from Europe, North America, and Japan. The English is generally excellent, considering that for so many of the authors English is not the language of choice. The book provides many original references, but adopts the unsatisfactory habit of citing many other authorities without giving any reference to their work. British readers will be fascinated to see how geriatric problems are tackled outside the Welfare State. Rehabilitation aspects are dealt with inadequately, considering the vital role they play in geriatrics. Limb contractures are not discussed, and pressure sores are barely touched upon. The haematological chapter is not good; the gastroenterological one is stimulating, but post-gastrectomy malnutrition as an entity is not discussed. Some surgical aspects in the care of the elderly are well dealt with in a medical setting, and the chapters on otorhinology and ophthalmology are good and interesting.
excellent contribution on diabetes mellitus and a the menopause and postmenopausal condifascinating tions (subjects not dealt with in previous geriatric textbooks). The scientific basis of geriatric practice is emphasised throughout (e.g., the irrational use of vasodilators and vitamins is discussed and subsequently deprecated). With its multiple authorship and multinational origin, the book does not claim to be a systematic textbook. However, with its English, French, and German editors it will be a useful reference work, especially for doctors throughout Europe in whose daily clinical work geriatric medicine plays such a large part.
There is
an
one on
Cobalamin, Biochemistry and Pathophysiology Edited
by BERNARD M. BABIOR, M.D., New England Medical Hospital. New York and Chichester: Wiley. 1975. Pp. 477.$25; £13.
Center
VERY few books have been written about vitamin B,2, and of them were published many years ago. Fortunately Dr Babior has now provided clinicians and basic scientists with an up-to-date review about the cobalamins (vitamin-B12 compounds). The first few chapters are devoted to their chemistry, biosynthesis, and coenzyme functions. Most of this section deals with the details of bacterial systems and will be mainly read by biochemists. The second part of the book is devoted to pathophysiology and will be of most interest to clinicians and hsmatotogists. The opening chapter by Ellenbogen contains a good account of intrinsic factor and the transcobalamins. The next chapter, by Linnell, describes his recent studies on the distribution of the cobalamins in normal subjects and in patients with hxmatological or neurological disorders. He also gives an interesting account of a new inborn error of vitamin-B12 metabolism. Mahoney and Rosenberg then summarise the other metabolic errors and Donaldson deals with the mechanisms of malabsorption of vitamin B12. The final chapter, by Beck, takes a critical look at the metabolic features of vitamin-Bl2 deficiency and challenges many of the current explanations for the megaloblastic ana:mia. This book is essential reading for all ha!matologists and for anyone else interested in vitamin B12. most
Stroke and its Rehabilitation Edited by SIDNEY LicHT, M.D., New Haven, Connecticut: Elizabeth Licht. London: Lloyd-Luke. 1975. Pp. 504.$20; £11.
THIS is an excellent American textbook by fifteen contributors, the editor himself contributing three clear, concise, and informative chapters. The chapter on the history of stroke shows how a large number of historical facts can be presented concisely and in a way that sustains the reader’s interest. Dr Licht deals in detail with the stroke rehabilitation programme, drawing on his day-to-day clinical experience, and contributions on physical therapy, neurophysiological therapy, and speech disorders follow on naturally. The chapter on occupational therapy, written by a physician, could be used as a model for planning an occupational-therapy programme in a stroke unit. Much use is made of illustrations from the British
1020
publication Help Yourselves, but many references are incomplete. The section on wheelchairs may be of less value to readers outside the United States but it still gives a clear indication of some of the pitfalls in requesting wheelchairs. The contribution on nursing maintains the high standard and gives a detailed account of the management of stroke patients at all stages of their illness. The earlier chapters deal with the natural history, pathology, pharmacology, and surgical management of strokes; though excellent in themselves, they contain a certain amount of repetition which the editor should have prevented. The chapter on pathology devotes an undue amount of space to angiomas, and the view of hypertension related to stroke is hardly in line with current medical thought. However, the book and illness. text
as a
can
handbook
be recommended both as an academic the everyday management of stroke
on
Index of Suspicion in Treatable Diseases
MANY physicians have something of a surgeon’s spirit within them in their quest for treatable disease. It is right to emphasise treatable diseases in teaching and in practice, but whether or not a disease is treatable is a poor path to fuller understanding and inadequate as a basis for classification. Thus this book-written for a rather unrealistically wide audience of innurses, paramedical personnel, specialists seeking knowledge outside their own specialty-may confuse by its arbitrary ordering and mislead by its dogmatic brevity. The early sections on abdominal and gastrointestinal disease, for example, are, successively, achalasia, hiatus hernia, hypertrophic pyloric stenosis, Zollinger-Ellison syndrome, peptic ulcer, and chronic active liver disease; several more sections follow before the eminently treatable condition of acute appendicitis is reached. If treatment be the source of inspiration, phaeochromocytoma might well have headed the hypertension chapter; but it appears fourteenth in a list opened by high arterial pressure ("big pulse") and high systolic pressure (arteriosclerotic hypertension). Later in the same chapter hypertension due to non-urxmic pyelonephritis (unhelpfully subtitled Butler-Longcope effect) is discussed in the light of two 1937 references. As an instant guide to treatable disease or suspicion of it, this compendium, though elegantly produced, is unsatisfactory.
ternists, general practitioners, and
Famine and Human Development The Dutch Hunger Winter of 1944-1945. ZENA STEIN, MERVYN SUSSER, GERHART SAENGER, and FRANCIS MAROLLA, Columbia University and New York State Department of Mental Hygiene.
University
Press. 1975.
Progress in Neurological Surgery Vol. VI. Edited by H. KRAYENBUHL, P. E. MASPES, and W. H. SWEET. Basle: Karger. White Plains, N.Y.: Phiebig. Chichester: Wiley. 1975. Pp. 489. Sw. fr. 160;$66.75; k23.30
THE sixth volume of this important series concentrates on neurosurgery of the pituitary. The editors are to be congratulated on getting together an authoritative panel of authors who can write clearly and informatively about their experience and technique. The first chapter, on clinical physiology and pituitary tumours, is a most useful summary of pituitary-function tests. The basic pathology of pituitary tumours is reviewed, and there is an additional and interesting chapter on the elec-
microscopy of these tumours. However, the chapters on technique are the most important, and this volume gives the experience of experts in different approaches to the pituitary, including transsphenoidal and stereotactic surgery. Two interesting chapters on heavy-particle irradiation and Bragg peak proton hypophysectomy will be of particular interest as more proton beams become available. The final two chapters from Zurich on chordomas and chondromas give that centre’s wide experience with both lesions. The literature reviews are excellent, but in view of the reputation of the Zurich microsurgical techniques it is disappointing to find no illustrations on this aspect. The whole book is an excellent review of thought and practice, and is strongly recommended. tron
Edited by ORVILLE HORWITZ, M.D., and JOSEPH H. MAGEE, M.D., University of Pennsylvania School of Medicine. Philadelphia: Lea & Febiger. London: Kimpton. 1975. Pp. 574.$29.50; /:14.75.
New York and London: Oxford
ditions but that the reserve is sufficient for function to be unaltered. This hypothesis accords with experimental work, but is even more difficult to test than the original one.
Pp.
284.
$12.95 (hardback), 4.50 (paperback). IT is going to be very difficult to test prospectively in man the hypothesis, drawn from animal experiments, that later mental developmental is adversely affected by nutritional deprivation in utero. Dr Susser and his colleagues are making an attempt, by giving measured food supplements to pregnant women from a population with under-average nutrition, but their completed study is retrospective-and the results were negative. A check on the mental competence of young Dutchmen of military-service age who had been born after the disastrous winter famine of 1944-45 revealed no relation between prenatal nutrition and mental competence. The results, together with other variables studied, have been published previously, but it is useful to have the whole inquiry gathered in one place. If mental performance is affected only by more severe undernutrition than the Dutch experienced that wartime winter a generation ago, then a worse-off population would have more conspicuous problems than depressed mental competence. The Columbia University team thinks that the most likely explanation for its negative finding is the possibility that brain cells really are depleted under these con-
A Manual for Medical Assistants and other Rural Health Workers BO BALLDIN, RICHARD HART, ROLF HUENGES, and ZIER VERSLUYS, Kilimanjaro Christian Medical Centre. Obtainable from African Medical & Research Foundation, P.O. Box 30125, Nairobi, Kenya. 1975. EA Sh 10. The Training of Auxiliaries in Health Care KATHERINE ELLIOTT. Obtainable from Intermediate Technology Publications, 9 King Street, London WC2E 8HN. 1975. Pp 110.
;1.50. THE 28th World Health Assembly in Geneva placed a new on the development of primary health care in the drive towards the promotion of national health services. In many countries success in primary health care will depend on a massive programme of training of auxiliaries and part-time health workers, as in Tanzania. Training-centres need suitably written textbooks, and Dr Elliott’s excellent annotated bibliography of the material specifically written for the training of auxiliaries shows that few such books have appeared-though, as her guide also shows, many centres have been set up. The African Medical and Research Foundation is attempting to fill this gap, and the useful book on child health by Dr Balldin and his colleagues is the first of its publications. Problems arise when doctors try to write for medical assistants. Maurice King in his Nutrition for Developing Countries (1972) made perhaps the first attempt to write a book in simple English, with plenty of illustrations and a limited vocabulary. In the book from Kilimanjaro some attempt has been made to simplify the English, but the vocabulary is still extensive. The book contains several illustrations, but for the readership aimed at an illustration every two pages is needed; Dr Balldin’s group has not provided so many, nor are the ones included wholly suitable for the printing method used. The usefulness of the book will depend on the level of auxiliary available. However, the authors have covered child health reasonably well, and this book should make a real contribution to the training of the many thousands of auxiliaries who will be needed if childhealth services are to be made available to the widespread populations in rural areas such as East Africa.
emphasis
