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Musculoskeletal Examination

by Geoffrey M Gross MD, Joseph Fefto MD and Elaine Rosen. Blackwell Science, London, 7996 (ISBN 0 86542 410 1). Illus. 486 pages. €29.95.

This book provides a useful refer- ence text for those undertaking physical examinations and for those learning basic assessment skills. It is subdivided into 14 chapters, the first of which describes the purpose of physical examination, containing a brief description of the compo- nents of the musculoskeletal sys- tem. The second chapter explores the basic concepts of physical exam- ination describing some of the tests included in the assessment process.

Phalen’s test: This position is held for at least 60 seconds

The procedures are dealt with briefly, tending to rely on anecdotal descriptions. Unfortunately, there is little attention to the reliability, validity, sensitivity or specificity of any of the tests mentioned. This is a serious omission in a subject area where interest is increasing.

The remaining chapters address assessment of each joint or section of the spine sequentially. There are numerous diagrams to illustrate the tests described. Many are useful although others, for example those demonstrating the ulnar nerve test, are difficult t o interpret.

The strength of the book lies in the surface anatomy and surface marking of many anatomical land- marks, facilitated both through description and diagrams. A ref- erence copy of Musculoskeletal Examination in the departmental library would be advantageous for those working in out-patients as a

guide to physical examination. I t would also be suitable for student physiotherapists learning assess- ment techniques.

Many books describing assess- ment procedures fall into the trap of providing students with a list of questions, but provide little help with interpretation of the informa- tion that this generates. This text is no exception. The absence of critical evaluation of the assessment proce- dures presented and the lack of referenced reports where many of the procedures have been evaluated limit the usefulness of the book to those seeking a greater depth of understanding.

Michele Harms PhD MSc MCSP

The Family Encyclopaedia of Homoeopathic Remedies - Safe and natural homoeopathic treatments for conditions of every kind by Dr Peter Webb, Robinson Publishing, London, 1997 (ISBN 1 85487 469 1). 564 pages. f 9.99.

After a short introduction, which explains homoeopathy, this book is arranged in three parts. Part 1 is entitled ‘Common Illnesses and their Remedies’. The illnesses are then grouped into easily identified sections such as nose problems, heart and circulatory disorders, and so on.

The author begins each section with a description of the disorder, the aetiology, signs and symptoms. There follows a list of suggested remedies based upon the ‘remedy picture’. This is a method which identifies the remedy according to symptoms displayed by the indi- vidual, rather than prescribing only for the disorder.

Hahnemann, who demonstrated homoeopathy in 1806, devised the method by experimenting on himself and other healthy subjects. The remedy pictures were contrived from the symptoms they developed.

The two remaining parts of the book follow a similar format. Part 2 covers problems of newborn babies, infants, children and adolescents; and part 3 covers special disorders of adults, including HIV infection, menstrual difficulties and problems of the elderly. The book concludes with an index, a list of homoeo-

pathic pharmacies, Internet web sites, other useful contacts and suggested further reading.

The author of this book practised as a GP, during which time he trained as a homoeopath. His stated intention was t o produce a book which enabled readers to treat certain illnesses with homoeopathic remedies, although he warns that a medical diagnosis should be estab- lished before using homoeopathic remedies. A publisher’s disclaimer further states that the book is intended as a reference volume only, not a manual for self-treatment. This clearly negates the author’s original intention and excludes the book from the category of a self-help manual for the family, which is what i t purports t o be on first inspection.

The list of illnesses covered is comprehensive and is informative for the lay reader. A short descrip- tion of each condition is followed by the suggested homoeopathic remedies, including remedies for mischievous behaviour, fear of dentists and dyslexia. Should the remedy cause an aggravation of symptoms, the reader is advised to drink several cups of strong coffee as an antidote.

The author relies heavily upon Hahnemann’s original theories, but no attempt is made to support these with research reports or reference to other literature. Thus, the reader is required to have an unquestioning faith in the efficacy of such remedies as tuberculin (the nucleo-protein from a tubercular abscess) and medorhinum (gonorrhoea bacteria). The author gives an assurance that these ‘nosodes’, derived from diseased tissue, contain no mole- cules of the original substance.

Inquiring readers may feel the need for a further explanation about how lyssin (saliva of a rabid dog), ambra grisea (morbid secretion of the whale) and variolinium (smallpox postule) are obtained.

The book may be of interest t o a lay reader but falls short of the standard required by most health professionals. Physiotherapists with an interest in homoeopathy are advised to seek a more authoritative text. The book may have a place as a work of reference in the comple- mentary health section of a library.

Eileen Cook MCSP

Physiotherapy, February 1998, vol84, no 2