Independence, Ill (later Oakland), wealth of historical information
where he was the only medical\x=req-\ about medical practice in the rural
school-trained physician. In the early
years his practice consisted mainly of
house calls, requiring long hours on
horseback through soaking rains,
blizzards, deep mud, high water, for-
ests, and prairies. He particularly
loved the prairies: "The eye will never
tire of the flowers of the wilderness
and of the prairie: and the scent of
their blooms and the brightness of
their colors.... The eye can view mile
upon mile and still rest upon an
endless expanse of green." Late sum¬
mer was the major "sickly season,"
owing to the remittent fevers of ague,
which was most often malaria. Al¬
though quinine had been available
since 1823 in the United States, Dr
Rutherford apparently did not have it
for his beloved Lucinda, who died of
remittent fever after acquiring it at a
Methodist camp meeting.
Unfortunately, the Rutherford let¬
ters stopped after his wife's death,
and he did not write again until 1877,
when he retired from practice. Then
in a series of newspaper articles col¬
lected later for publication, he re¬
called many of the early characters of
the town, from preacher to alcoholic,
judge to backwoodsman. Particularly
important to historians is his exciting
account of the Matson slave case, in
which he actively participated in sup¬
port of a family of slaves. The oppos¬
ing lawyer was Abraham Lincoln,
who inexplicably defended the slave
owner and lost the case.
Several other Illinois physicians'
papers and memorabilia in the book
by Crellin provide a more general
look at medical practice. Many issues
of concern today had already surfaced
in the last century, including physi¬
cian advertising, fee schedules, quali¬
ty of care, and economic competi¬
By 1832, there was concern about
tion.
too many physicians: "The Western
country is completely inundated with
Doctors." Rivalry became keen and
enmity bitter as restless and oppor¬
tunistic physicians moved around the
state and in from the East, often
seeking advice on practice locations
from druggists. Competition was also
notable from unorthodox and itiner¬
ant practitioners, schooled in phre¬
nology, homeopathy, and botanical
medicine, who flourished as patients
wearied of "heroic" therapy with
calomel and bloodletting. More uni¬
form standards of practice emerged
after 1877, with the establishment of
the State Board of Health and the
advent of medical licensing.
Overall, these books present a
Downloaded From: http://jama.jamanetwork.com/ by a University of Manitoba User on 06/08/2015
Throughout the years everyone will
undoubtedly develop favorite books to
Midwest, probably typical of many
states. They make interesting and
enjoyable reading and provide food
for thought about our medical heri¬
tage.
E. Dorinda Shelley, MD
Toledo
Staying Healthy
Staying Healthy Without Medicine: A Manual
of Home Prevention and Treatment, by Daniel P.
Marshall, J. Gregory Rabold, and Edgar S. Wilson,
292 pp, with illustrations by Mick Walsh, $27.95,
Chicago, Nelson-Hall Inc, 1983.
The self-care movement and clini-
cal medicine seem to have an uneasy
relationship. Physicians fear that pa-
tients may unnecessarily delay seek-
ing treatmentby misguided applica-
tion of self-care concepts. Many
patients, conversely, want to have a
"The self-care movement and
clinical medicine seem to have an
uneasy relationship."
greater and active role in their
more
personal medical What can be
care.
done? One solution in recent years
has been the spate of conferences,
books, articles, and pamphlets on the
concept and practice of self-care for
the layperson. Because most physi-
cians want their patients to partici-
pate effectively in prevention or
treatment of illness, there is a real
need to help patients find appro-
priate sources of self-care informa-
tion.
The three physician authors of
Staying Healthy Without Medicine
have produced a highly readable,
well-organized book that seems to
provide competent self-care advice for
prevention and treatment and that
encourages self-care, without discour-
aging the doctor-patient relationship.
It is unusually well written, in my
judgment. Each concept is carefully
and briefly explained to the reader in
a refreshingly collégial tone;that is,
the authors neither condescend¬
are
ing, nor overly technical in the expla¬
nations of etiology, symptoms, and
self-care management. Some chapters
are simply superb. For example, the
authors' handling of sexual relation¬
ships (pp 89-99) could be profitably
read by most physicians as well as
patients, because of its sensitivity,
openness, and factual presentation.
Throughout the book the currency of
information will be a pleasant sur¬
prise to the knowledgeable reader.
recommend to patients as a home
resource for self-care. This one can be
usefully added to one's list; in fact, it
just might deserve being at the top.
Charles B. Arnold, MD
Metropolitan Life Insurance
New York
Company
Orthopedics
Textbook of Disorders and Injuries of the
System:
Musculoskeletal An Introduction to
Orthopaedics, Fractures and Joint Injuries,
Rheumatology, Metabolic Bone Disease and
Rehabilitation, by Robert Bruce Salter, ed 2; 578
pp, 1,353 illus, $37.95, Baltimore, Williams & Wilkins
Co, 1983.
This second edition appears 13
years after the initial effort to orga-
nize and teach injury and disorders of
the musculoskeletal system on a level
intelligible to the orthopedic student.
While the first edition was well
received and represents a notable
contribution to this field, the second
edition has followed in this tradition
and has been substantially updated
according to current orthopedic
thought. The strengths of this text
parallel those of its predecessor.
"... the entire work conveys the
spirit of compassion and places
emphasis on patient care ."
. .
Probably one of the most impressive
features is the masterful organization
of the broad, complex, and difficult
scope of orthopedics. The synthesis
and organization of this body of
knowledge are superb.
The first section deals with the
scientific approach to understanding
orthopedic pathology. Not only is the
structure and development of bone
and cartilage concisely related, but
troublesome clinical terms, such as
varus and valgus, anteversion and
retroversion, are clearly defined in
this section; this difficult terminology
might otherwise confuse or even dis-
courage the student. Assessment of
the musculoskeletal system is not
limited to the physical examination,
but the indications and values of
adjunctive diagnostic tests are well
described. Treatment is also de¬
scribed, from the simple techniques of
traction, splints, and casts to the
more complicated treatment modali¬
ties of joint replacement, all placed in
a proper clinical and scientific per¬
spective.
The section dealing with disorders
of the musculoskeletal system appro¬
priately begins with normal variation
 followed by congenital anomalies.
Each chapter provides a delicate
balance of emphasis for what might
otherwise be an overwhelming sub¬
ject to the student exposed to these
data for the first time.
The section on inflammatory pro¬
cesses of bone and joints is thorough
and compactly organized with an
excellent blend of the basic science
with respect to the pathogenesis of
the processes as well as a concise
outline of available treatment modal¬
ities and an explanation for the basis
of treatment. Salter's ability to syn¬
thesize and organize remains evident
throughout the remaining chapters of
the book and is no more obvious than
in the section with neuromuscular
disorders with descriptions of pathol¬
ogy and treatment divided according
to disorders of the brain, cord, and
peripheral nervous system.
The firsthand experience gained
through a career of clinical and basic
investigation of disorders of the carti¬
lage and growth plate provides au¬
thority to the discussion in this sec¬
tion. However, these areas, despite
their being of special interest to the
author, do not receive an undue
emphasis compared with the remain¬
ing subject matter.
The final sections deal with general
and specific injuries to the bones and
joints of both children and adults.
The development of these chapters
allows the student to obtain an orien¬
tation to the specialty, which should
provide him with a scientific basis of
clinical practice.
One must look long and hard for
negative features of this textbook. As
a textbook, the reference list is ade¬
quate, but not exhaustive. Relatively
small-sized reproduction of many
clinical examples is slightly distract¬
ing. The double-column format also
necessitates the orientation of some
clinical and radiographie examples in
a way that is not familiar to many
clinicians. This may become annoy¬
ing, but probably more so to someone
experienced in orthopedics and not so
much to one who is just learning the
subject. The index, while thorough,
does not provide an easy reference
from an anatomic standpoint, for
example, for diseases of the hip,
elbow, or femur.
This work is a substantial under¬
taking that demonstrates the founda¬
tions of orthopedics and is presented
with a masterstroke of organization
and illustration. Probably most im¬
portant, the entire work conveys
the spirit of compassion and places
emphasis on patient care—elements
Downloaded From: http://jama.jamanetwork.com/ by a University of Manitoba User on 06/08/2015
that cannot be overemphasized to the
person just learning this specialty.
We would recommend this work
without reservation to medical stu¬
dents interested in orthopedics, to
scientists doing research in this area,
and to the person in the early years of
residency.
B. F.
MORREY, MD
Mayo Clinic
Rochester, Minn
Nutrition
Nutritional Support of Medical Practice,
edited by Howard A. Schneider, Carl E. Anderson,
and David B. Coursin, ed 2; 702 pp, 132 illus,
$37.50, Philadelphia, Harper & Row Publishers Inc,
1983.
This popular book has appeared in
a second edition, six years after its
initial publication. The majority of
the book has been redone; about 25%
of the authors are new in this edition.
The authors are a rich mixture of
nutrition scientists, specialist physi-
cians, and dietitians presenting most
of what is known about human nutri-
tion in 36 chapters. These consist of
four chapters on the physiological
basis of nutrition, ten addressing the
major modalities of applied nutrition,
and 22 chapters on specific disease
entities or frequently encountered
nutrition problems.
Outstandingly written and illus-
trated chapters are presented on
"Community Nutrition Resources,"
"The Nutrition Support Service in
Hospital Practice," and "Protein-Cal-
orie Malnutrition and Its Manage-
ment." Excellent chapters address the
treatment of burns, endocrinology
and nutrition, and geriatrics. In con-
trast, the introductory chapters,
those addressing curative nutrition\p=m-\
vitamins, diabetes, and neurological
disease\p=m-\arejust not up to date with
many of the concepts in the current
literature. Most of the remaining
chapters are solid reviews of the
pertinent information, but fall short
of excellence by the nature of the
prose or the organization of the con¬
cepts in relation to other parts of the
book.
There are useful tables in the
appendices that cover recommended
allowances, 1983 weight for height
standards, growth curves and head
circumferences for children, recom¬
mendations for trace elements in
parenteral hyperalimentation, and
hard-to-find data on such things as
caffeine and fiber content, nutritive
value of desserts and snack foods, and
the food value of alcoholic beverages.
Overall, the book is good or very
good in at least 75% of its chapters.
The editors have done a fine job in
recruiting new authors and in render¬
ing the book more timely.
Compared with existing books, this
one presents the role of the nonphysi-
cian better and discusses the impor¬
tant area of nutrition support ser¬
vices in hospitals in an up-to-date
manner. The clinical sections are
strong and pertinent, but many of the
chapters held over from the first
edition do not seem in step with the
1983 to 1984 problems and should be
carefully reviewed for the next edi¬
tion. The book is particularly recom¬
mended for hospital and outpatient
teaching facilities. It is not as great a
value to medical students as other
volumes could be.
Frank L. Iber, MD
University of Maryland
School of Medicine
Baltimore VA Medical Center
Psychiatry
International Encyclopedia of Psychiatry,
Psychology, Psychoanalysis, and Neurology,
Progress Volume 1, edited by Benjamin B. Wol-
man, 509 pp, New York 10023 (10 W 66th St),
Aesculapius Publishers, 1983.
The Progress Volume 1 follows five
years after the 12-volume encyclope-
dia. It is integrated with the former
works through alphabetical titles and
listings, major cross-reference topics
and references, and name and subject
indexes.
More than 124 authors have con-
tributed to the present volume, about
50% of these with PhDs, somewhat
fewer with MDs. The multidiscipli-
nary goal is kept in mind where
appropriate.
Because the reviewer took the title
of the work Progress Volume 1 to
mean recent scientific advances since
the previous volumes, it was perplex-
ing to read in the preface that the
previous reports "are as up-to-date as
they were 5 years ago, and only
certain limited areas required a new
approach and a fresh appraisal." Fur-
thermore, when four biographies of
scientists who died in 1904,1914,1925,
and 1928 are included as "progress,"
some explanation is necessary. In
addition, the latest reference in one
article was from 1959, in another
from 1969, and in several articles
there were no references within the
past six years; it is questionable what
the selection criteria were to be. With
one article, there were five references,
all by the present author and dating
from 1969 to 1980.
The "international" part is repre¬
sented by Colombia—psychology in a
little more than two pages, Israel—