BOOK REVIEWS

The Palmar Fascia. By H. GRAHAM STACK. burgh and London: Churchill Livingstone, 1973).

Pp. vii+236, with 27 Illustrations. (Edin- Price E8.00.

The subject this monograph an interest of it provided in 1970. Indeed, is really an expansion this lecture,

which on an examination of serial sections of foetal hands made to the author for study by Professor Landsmeer at the Anatomy of the University Leiden. This, coupled of Dupuytren’s contracture, by the author this volume.

is in In the first in very great detail the anatomical changes the various of the hand, to just distal to the web. is followed by an analysis of fo Dupuytren’s contracture.

of the book of the in extenso, translated and edited, writings on the subject of the palmar fascia of some 30 authors, from Albinus in 1734 right up to the present day.

There is no doubt that this book contains an extraordinarily full account of the anatomy of the palmar fascia and its thickenings in Dupuytren’s contracture, but the reviewer emerged from reading it a little bruised from rhe sheer weight of detail and inevitable repetition, particularly since much of the first half is repeated many times over in the second half as each of the 30 authors provides his own description of the fascia under discussion.

The reader might with profit have been spared much of the evidence on which the subsequent analysis and conclusions are based. This part of the book is more suited to a CbM. Thesis than a monograph. The analysis and conclusions are ihe meat of the book and they are contained in 30 pages. This-is ihe part relevant to surgical practice the part likely to be of most interest to the surgeon as opposed to the anatomist.

I. A. MCGREGOR

Plasties Mammaires pour Hypertrophie et Ptose. By J.-P. LALARDRIE and J.-P. JOUGLARD. Pp. 188 with 90 illustrations. (Paris: Masson et Cie.).

This book has appeared most opporrunely; the literature on mammaplasty has expanded exponentially in recent years and the authors have performed a great service to plastic surgery in collecting and reviewing it so thoroughly. There are almost 500 references and they are right up to 1973.

The first chapter deals with the anatomy and shape of the “normal” breast. They conclude that there is no “ideal form What is important is that it should be of pleasing form and free of prosis.” A breast volume around 2;~ ml. is about right: below 200 ml. the breast looks underdeveloped; above 350 ml., while attractive to some, the risk of early ptosis increases. The second chapter attempts to describe and define what is meant by mammary hypertrophy and mammary ptosis. Such definitions and that of “normality” are of course arbitrary but a great deal of wisdom is distilled in these chapters. The authors go on to describe the wide variety of mammaplasty techniques which have been published, how modern ideas gradually evolved, and the indications for each, and the results. This part of the book is mainly illustrated by simple but effective line drawings and one can rapidly compare the different techniques, such items as the shape and extent of the area which is de-epithelialised, the site from which the excess breast tissue is excised, the way in which the remaining breast tissue is rearranged and so on. There are, however, before and after photographs of the most commonly used techniques of the present time; courageously they have published almost as many photographs of poor results to illustrate how not to do it.

There is a good summary in English at the end of each chapter and the captions appear in both French and English. These and the very clear drawings make the book available to a much wider reader- ship than those who can easily read French. It is strongly recommended to every plastic surgeon who is concerned with the aesthetic surgery of the human breast.

T. GIBSON

The Artificial Larynx. By YVAN LEBRUN. Pp. 90, with 68 illustrations. (Amsterdam: Swets and Zeitlinger B.V.) Dutch guilders 25.-

This is a fascinating account of man’s efforts past and present to restore normal speech to patients whose larynx has been removed. The first gadgets a century ago attempted to lead vibrating air from the tracheostomy tube directly through a tube into the pharynx. But preventing food from entering the apparatus was a problem and external pneumatic devices were evolved and are still in use. They all