BOOK REVIEW

Clinical Endocrinology : Principles and Practice by David Rabin and T. Joseph McKenna, 1982. Grune and Sttraton. Price s

Clinical Endocrinology is the 9th volume in a series 'The Science and, Practice of Clinical Medicine' (series editor John M. Dietschy, M.D.), and it completes a set of texts which cover the major sub-specialties.

It is the product of a fruitful collaboration initiated in the 1970s between Dr. David Rabin, Professor of Medicine, Obstetrics and Gynaecol- ogy at Vanderbilt, and Dr. Joseph McKenna, now returned to Ireland. It is a large, comprehensive book, running, with references and index to 652 pages of high-quality, double column print. The diagrams, figures and tables are clearly laid out, and easily interpreted.

The general format is conventional. There is a useful introductory section on general endo- crine principles, emphasizing the relationships between hormones and growth factors, neuro- transmitters, closed-loop control systems and bio-rhythms, receptors and the 'second messen- gers'. Each major glandular system is then covered in a logical sequence, starting with rel- evant embryology, gross and microscopic anat- omic features, physiology, and, especially in the section related to Diabetes Mellitus, comprehen- sive relevant biochemistry and intermediary fuel metabolism. Pathophysiology, clinical features, diagnostic measures and treatment follow. There is an extensive bibliography after each major secional subcfivision, providing useful references for further reading. There are useful practical sections on the approaches to various clinical problemsqsuch as the hypo-osmolar syndromes, the amenorrhoeas, and infertility (with a special section on varicocoele--though surprisingly, no mention of intravenous pyelography in its investi- gation). The pluriglandular and para-endocrine syndromes receive attention, with a special sec- tion on Mastocytosis. Apart from the rare pan- creatic tumours, and carcinoids, there is however, little on the rapidly-expanding topic of gastro- intestinal hormones. There are brief accounts of malignant hypercalcemia and of ectopic ACTH in the relevant sections, but, apart from these, there is relatively scant discussion on ectopic hormone production.

Most recent endocrine texts of this size have been 'multi-author" because of the breadth of knowledge and complexities extant in the differ- ent endocrine sub-specialties. The two authors of the present text have covered an enormous amount of work to familiarize themselves and distill aspects of endocrinology outside their own particular interests, and any disadvantage from lack of of multiple authors is more than offset by uniformity of style and presentation, and the ability to dispense discussion on topics which 'overlap' between chapters, to one chapter alone. For example, pituitary gonadotropins are dealt with only cursorily in the section on Pituitary, but receive very full coverage, including biochem- istry, physiology and pathophysiology, in the Ovary section. In addition, the authors have been able, as they say in the Preface, to empha- size their own endocrine experiences, and the experiences of their colleagues, and this is also reflected in the literature references.

The sections on thyroid, the ovary, and on diabetes are particularly good, striking a balance between the inevitable basic biochemistry neces- sary for understanding, and the practical medi- cine and therapeutics necessary for patient management. However, in the treatment of Paget's disease, diphosphonates (possibly the current treatment of choice) should be given relatively more prominence than the cytotoxic drug Mithra- mycin (now used much less than before).

Notwithstanding inevitable subjective opinion differences here and there (e.g. on reference selection), Drs. Rabin and McKenna are to be congratulated on producing a very good result to much dedicated reading, writing, cross-refer- encing and application generally which is neces- sary to produce this kind of book. It will fill a useful position in the literature between, on the one hand, the small endocrine handbooks suit- able for students and housemen,, and, on the ether, the multi-volume multi-author texts on endocrinology used by specialists. This book is to be recommended to all who wish to obtain, in one volume, the important principles of bio- chemistry and physiology on which endocrinology is based, together with practical principles of management of endocrine disorders.

DAVID POWELL.

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