PSYCHOSOMATICS

generation, loss of myelin, and intense glial prolifera­tion.

The psychoneuroses are handled superbly. In amere seventeen pages, a most lucid presentation pro­vides the reader with information than can be readilyabsorbed, digested and assimilated. Similarly, in thehandling of the psychoses, the needs of the non­psychiatrist are most adequately met.

Despite the fact that this reviewer utilized thesingle volume (it can be purchased as a two-volumeedition), the content of this most excellent text easilycounterbalanced any pOSSible effect of managing abook which weighs nine pounds.

W.O.

MEDICAL PHYSIOLOGY. Second Edition. By Dr.Arthur C. Guyton. 1181 pages. Philadelphia: W.B. Saunders Co., 1961. $15.50.

The author, in this massive second edition, hasundertakl'n a Hereulean task. The contents arc wellorganized into thirteen parts as follows: Introduc­tion to Physiology, Body Fluids, Blood, Peripheral,Nervous and ~Iuscular Systcm, Heart, Circulation,Respiration, Aviation and Deep Sea Diving, CentralNervous SyslPm, Alimentary Tract, Metabolism andTemperature Regulation, Endocrinology and Repro­duction and Radiation.

Thesc parts arc divided into 82 chapters, eachof which is highly descriptive and informative. Theauthor gives due praise to the 120 different physio­logists, to whom he submitted almost every chapterof the book for their critical appraisal both as tofactual material and manner of presentation. Theresult is a book which not only portrays up-to-datethought on a particular subject but one which is ex­ceptionally well written and enhanced by clear draw­ings, tables, electrocardiograms and excellent refl'r­ences.

The author, undoubtedly a master in the field ofphysiology, has attemptcd to present the humanbody as a single functioning organism, controlledby innumerable regulatory systems, with emphasis onthe automatieity of the life processes. Throughoutthe text the prineiples of control therapy arc dis­cussed as they apply to speeific bodily mechanismsand much attention has been given to the inter­relationships of functions of the different organ sys­tems of the body.

This book could be read by physieians in everyfield with profit but with the greatest profit by theinternist.

BURTON L. ZOllMAN, 1\1.0.

RESISTANCE OF BACTERIA TO THE PENICIL­LINS. Ciba Foundation Study Group No. 13.Edited by A. V. S. deReuck and Margaret P.Cameron. 125 pages. Boston: Little, Brown &Co., 1962. $2.95.

Twenty-two microbiologists, biochemists, geneti­cists and research scientists of international caliberparticipated in this study group at the Wolfson In­stitute, Postgraduate Medical School, London, Febru-

136

ary 2, 1962. England, France, Italy, Israel, Den­mark, Belgium, Sweden and the U,S.A. were repre­sented. The symposium is a follow-up to one heldfive years previously on Drug Resistance in Micro­organisms.

The discovery of penicillins that combine anti­biotic effectiveness with a high degree of resistanceto penicillinase is a development which is consideredhopeful in providing a more complete control ofstaphylococcal infections. It is known that staphylo­coccal strains rendered resistant to penicillin do notcontain penicillinase, while naturally occurring peni­cillin-resistant strains do. The staphylococcus is aversatile organism, although views differ considerablyabout the extent to which it may have been per­manently foiled by the latest developments in peni­cillinase-resistant antibiotics. There are four mainpossibilities for retaliation by this enterprising organ­ism.

1. It may evolve an alternative, penicillin-resist­ant mechanism for synthesizing its cell wall.

2. It may evolve a barrier to prevent access ofpenicillin to the vital center of attack.

3. It may evolve a mechanism for producingvery much larger amounts of penicillinase.

4. It may evolve or acquire additional informa­tion enabling it to produce an enzyme, perhaps bymodification of its present penicillinase gene, cap­able of attacking penicillinase-resistant penicillinsmore effectively.

The conclusion derived from this highly technicalbooklet is that the staphylococcus bacterium is anorganism which may become resistant to penicillin,and is capable of adapting itself to an altered envir­onment.

LEO WOLLMAN, M.D.

THE MANAGEMENT OF THE ANXIOUS PA­TIENT. By Ainslie Meares, M.D. Philadelphia:W. B. Saunders & Co., 1963.

Doctor Meares makes no pretense that this is a text­book containing all available information. It is a per­sonal account of the manner in which the authormanages the anxious patient. It is intended for thegeneral physician, rather than the psychiatrist; it doesprovide many helpful clues for those seeking simpleexplanations rather than theory and divergent opin­ions.

The author successfully illustrates the importance ofnon-verbal communication. He also demonstratesclearly that many patients can be restored to emo­tional homeostasis without an interminably prolongedperiod of psychoanalysis.

The various chapters include remgnition of theanxious patient, the common causes of anxiety, talkingwith the patient, the use of simple techniques toprovide relief, and common psychosomatic syndromes.

The value of this book is enhanced by the aVOId­ance of verbosity and the clarity of expression. Itshould be of value to all those seeking fundamentalunderstanding of the role of the physician in the man­agement of anxiety in his patients.

W.O.

Volume V