Aids To Clinical Examination

Postgraduate Medical Journal (1987) 63, 415-421
Postgrad Med J: first published as 10.1136/pgmj.63.739.415-a on 1 May 1987. Downloaded from http://pmj.bmj.com/ on May 20, 2020 by guest. Protected by
Book Reviews
Advances in Non-Invasive Nephrology. Proceedings of the tions (inspection, palpation, etc.). At the left side ofeach page
International Congress of Non-Invasive Diagnosis of Kidney catchwords are mentioned, followed by explanations and/or
Disease, held in Vienna. September 1983, edited by Gert additions at the right side. This division makes the book
Lubec and Vito Campese. Pp. xi + 300, illustrated. John easily accessible.
Libbey, London, Paris, 1985. £30, US$53, Ffr385. Some points of detail show (minor) shortcomings. For
instance in the chapter on diabetes mellitus too much
The cleverly conceived title ofthis symposium served to bring emphasis is laid on urinalysis, an examination which is
together workers from many different disciplines from all rapidly losing ground when compared with the daily blood
over the world to present what was in 1983 the latest in glucose profiles made by the patients themselves at home.
diagnostic techniques available to the nephrologist. Having Also it could have been stated in the chapter on thyrotox-
left full time nephrology shortly after this symposium I was icosis that the obvious form is nearly always caused by
distressed to find how much I did not know about the subject Graves' disease and that the hyperthyroid patient with a
even then and this book has been a delightful opportunity to multinodular goitre often has monosymptomatic disease
bring myself at least partially up to date. It has sections on (mostly tachycardia).
radiology and related imaging, non-radiological imaging On the whole, this book can be a useful aid for students and
techniques and a large section on biochemical methods, a may also be helpful for those physicians who are not very
third of which is devoted to urinary enzymes. There is a experienced in clinical examination. The book could well
section on pathophysiological background comprising a become as popular as the 'Aids' to undergraduate and
brilliant review by Jan Brod on hypertension, which should postgraduate medicine by J.L. Burton which was published
have a wide appeal. There is also an immunological section. earlier by the same publisher.
Inevitably the choice of subjects appears idiosyncratic and
incomplete but I have to say that very few of the 64 chapters J.W.F. Elte
fail to yield something of interest. I enjoyed particularly Department of Internal Medicine,
chapters on radiological and non-radiological imaging many St. Franciscus Gasthuis,
ofwhich gave a very good background to the techniques, and NL - 3045 PM Rotterdam, Netherlands.
sufficient information for radiologists interested in expand-
copyright.
ing their diagnostic facilities for nephrology patients. Most of
the chapters are quite short with well presented data and
illustration and the references given at the end of each An Autumn Life: How a Surgeon Faced His Fatal Illness, Ethel
chapter are consistent in style and seem to be well chosen Helman. Pp. 96. Faber, London, Boston, 1986. £2.95.
without being exhaustive.
The book is a must for nephrologists and I will lend it to In 1980 Percy Helman, an internationally renowned surgeon,
both my biochemical and radiological colleagues and I feel discovered that he was suffering from the very disease against
also that there is enough in it to interest the enlightened which he had been fighting throughout his professional life:
general physician. It is well worth its price of £30. cancer.
This is the story of how he, his wife Ethel, their family and
M.J. Weston their friends coped with the initial shock, the effects of illness
Chelmsford and Essex Hospital, on family relationships and the surges of optimism and
London Road, despair that accompanied the progress of the disease. It was
Chelmsford, Essex CM2 OQH. inspired by, and is based on tapes recorded by Percy Helman
as he monitored his own physical and mental reactions
during the two years of his illness. The tapes are, in part, a
medical record. They also reflect his hopes and fears as they
Aids to Clinical Examination, Peter C. Hayes and Ronald S. chart his response to the challenges his illness made upon
MacWalter. Pp. iii + 114, illustrated. Churchill Livingstone, him. His outlook on life was radically altered and his own life
Edinburgh, London, Melbourne, New York, 1986. £4.95. enriched by his dependence on others and by a greater
understanding of the needs of other cancer patients.
This book aims to be an aid both for undergraduate and Ethel Helman found the tapes after her husband's death.
postgraduate students. As the authors state in their introduc- Convinced that they were made for the purpose of helping
tion, many students have their own prepared cards as a help others to face the prospect of serious illness, she has
in clinical examination. This book may replace these notes integrated them with her own account of their experience as a
and could encourage systematic examination. family. An Autumn Life is a tribute to Helman's resilience and
In the first 9 chapters different organ systems and/or parts courage. It also confirms Percy Helman's claim that the last
of the body are reviewed. The remaining 10 chapters are months of his life, filled with a new compassion for his
devoted to selected clinical conditions. The framework of the patients and a more acute awareness of simple pleasure, were
book is well-organized, the discussion of the different for him the best time.
subjects sometimes amazingly complete (auscultation over This story was especially moving for me because it dealt
the eyeball!). with people's attitudes to death and to the dying. I have
All chapters are divided according to the kind of examina- always shied away from such a morbid subject, but since a
C The Fellowship of Postgraduate Medicine, 1987

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Postgraduate Medical Journal (1987) 63, 415-421

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