British Journal of Oral Surgery (1980) l&90-91

BOOK REVIEWS

Textbook of Oral and Maxilla-Facial Surgery. By G. 0. KRUGER. 5th Edition. St. Louis: C. V. Mosby, 1979, pp. 743, price 517.50.

At first sight this new edition appears to be an outstanding contribution to the literature with its distinguished list of authors, and profuse illustrations including some excellent line drawings. One accepts the transatlantic approach to exodontia as being different but on more detailed examination the text varies from idiosyncrasy to confusion in many crucial areas.

For instance, the chapter on cysts describes mucoceles and ranulas as being retention rather than extravasation phenomena and recommends marsupialisation for the latter; a sure way to produce a recurrence. The dental cyst section also describes primordial cysts and keratocysts as separate entities and without a single photomicrograph leaving those readers who regard them as synonymous in a state of wonder as to what classification is being employed.

The maxillary sinus chapter, after stating ‘epidermoid carcinoma of the antrum is more common than sarcoma’, then dismisses this important topic in a few words which include the highly question- able comment that metastases may cause death before local extension occurs!

In the antibiotic section, intramuscular penicillin is recommended to be given in the deltoid or triceps so that a tourniquet may be applied in the event of anaphylactoid reaction! There is also no mention of the dangerous clindamycin-induced colitis nor adequate practical advice on the manage- ment of acute drug reactions. I would disagree with the administration of antibiotics to a patient with osteomyelitis before drainage and sampling the pus for culture and sensitivity. Does one really need to insert tubes nowadays for irrigation of these cases?

Boyne is good on bone grafting but insists on calling allografts, homografts in the captions of his illustrations.

How should one respond to the statement that with bony ankylosis of the temporo-mandibular joint there is no choice but to establish a surgical juncture below the mass of dense bone, particularly as we now have excellent evidence that the costochondral graft (not described) is the best approach to this problem?

Haemophilia is mentioned in ‘Bleeding Disorders’ but without any reference to the use of cryopreci- pitate or antifibrinolytic drugs which have revolutionised the management of major surgical haemor- rhage problems.

The section on tumours is inadequate on the important dental care aspects of radiotherapy and completely out of date on the use of intra-arterial chemotherapy. The neurologicalchapter is better on leprous neuropathy and neurosyphilis than the common psychogenic facial pains and is unhelpful as far as their management is concerned.

In summary, the sections on pure surgical technique are on the whole good and profusely illus- trated. However, the standard of editing, particularly in relation to much of the included derivative material, leaves a great deal to be desired and I would not recommend this book for teaching purposes.

MALCOLM HARRIS

Textbook of Oral Biology. Eds. J. H. Shaw, A. R. SWEENEY, 0. C. CAPPUCCINO and S. M. MELLER. Philadelphia, London and Toronto: W. B. Saunders, 1978, pp. 1178, price f24.50.

The four editors tell us in their Preface that this very large textbook has come onto the market because ‘no textbook or even a small group of textbooks was available to help the students become versed in the rapidly progressing frontiers of the numerous and diverse facets in oral biology’. In this reviewer’s opinion, oral biology is an administrator’s or territory-hungry academic’s creation which need never have been conceived had departments of anatomy, physiology, biochemistry, etc., been prepared to take on competent dental graduates capable of teaching the oral aspects of these subjects. Now it has departments, professors and inevitably, therefore, undergraduate lecture courses and

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BOOK REVIEWS 91 postdoctoral (postgraduate in U.K.) students. This book is intended for postdoctoral students in North America and conceivably, therefore, might be suitable for Primary F.D.S. or Ph.D. students in this country. Primary F.D.S. students need not panic to obtain a copy. It will take some time for their examiners, with their faculties declining steadily, to read and absorb its 1100 pages. However, for the candidate who wishes to indulge in the dangerous game of one-upmanship with examiners, this book is a must.

I am quite incapable of expressing an opinion on the entire book. It almost requires a different reviewer for all of the 34 chapters written by 44 specialists. Indeed, since almost all of the writers are Harvard graduates, perhaps 34 reviewers would be inadequate. On the assumption that the general standard matches that of the chapters which I can understand, my verdict is that this is a good book, well written, well illustrated and carefully edited. The chapters on micro-anatomy of the oral minera- lised tissues and on the biology of the dental pulp covered both topics adequately, although in my view the rather important question of the extent of the odontoblast process in mature dentine could have been given more coverage. Neither in the chapters on pulp, nor on craniofacial pain was the problem of pain from teeth dealt with at a postdoctoral (postgraduate) level. In fact, the chapter on craniofacial pain was little more than an undergraduate lecture, only scratching at the surface in a field where an enormous quantity of work has been done in recent years. On the other hand I consider that the chapters on salivary glands, saliva and olfaction and taste are scholarly and at an appropriate level for the readers for whom the book is intended.

This is a book for libraries to purchase. If, having written this review, I am allowed to keep the book, I shall be glad to have it on my shelf as a useful reference source.

D. J. ANDERSON

Analytic Medicine, Volume I: Conventions. By Graham Rabey. Lancaster: M.T.P. Press Ltd, 1979 hardback, pp. 75, price g6.95.

Graham Rabey’s earlier work on ‘morpho-analysis’ is well known. It is a three-dimensional radio- graphic technique applied to the form of the head in its surface and skeletal shapes and proportions. But in this, the first of a projected series of volumes, he seeks to promote a regimen of logic, supported by Cartesian mathematics and a geometrical approach to changes in form to the systematics of knowledge on a wider scale. The text is difficult to understand, though illustrated with a great variety of most attractively produced diagrams. Many of these are familiar, being well-known views on bodily (chiefly cephalic) proportions. Many are, however, little more than the author’s attempts to categorize his own views on the parcellation of knowledge, which has been a topic for philosophers since Aris- totle, whose own articulation of the ‘sciences’ seems not particularly useful or even acceptable. Many of us may have played in our minds with a kind of total systematization of knowledge, and indeed the Universe. The results are to some extent obvious. Is it necessary to link form and function? Are they even separable? Are mind and matter really poles on an axis? Are we not all quite familiar with analysis and synthesis? Much that is obvious is somewhat obfuscated in this text by a kind of philosophic jargon, casting an apparently professional gloss upon classifications of knowledge which seem usually obvious.

The series, of which this is the first, is ‘written for undergraduate medical students’. Despite the superficial attractiveness of the book, which is beautifully produced, it must be doubted whether many undergraduates of any faculty would benefit greatly, if this first volume proves representative. Could not the author say what he wishes to say in a few pages? Beyond an indication that ordered and integrated study is profitable, it is not clear that anything more has been said, and it has certainly been said before. Vertical and horizontal integration, for example, are well understood, though it is pleasing to the eye to see them diagrammatized. But the author, like most educationalists, really does not tell us how integration in any direction is to be achieved. Integration of the kind over-praised in this book is in any case impossible. Knowledge is always gained sequentially. If you mix up sociological, physiological, biochemical and other data in integrated time, the result,is likely to be mania, not enlightenment. There is no easy road to ‘all-round’ knowledge of anything. Hard workis old-fashioned and yet new; the best integrated minds in the writer’s experience are those with an enviable capacity for work. True, they also know how to organise their knowledge, but this is not an intellectual strain and scarcely requires such extensive systematics.

ROGER WARWICK