450

but also denied.ll In animals calcium deficiency can leadto a condition resembling osteoporosis.9 12 Osteoporosiscan be demonstrated clinically in 25% of menopausalwomen,9 but densitometry shows osteoporosis in almostall women,13 and the bone mass is found to be reducedwithin 2 years of the menopause.14Young and Nordin 14 found a small but significant

increase in serum-calcium after the menopause. This

11. Urist, M. R. in Bone as a Tissue (edited by K. Rodahl, J. T. Nicholson,and E. M. Brown); p. 18. New York, 1960.

12. Gershon-Cohen, J., Jowsey, J. Metabolism, 1964, 13, 221.13. Davis, M. E., Strandjord, N. M., Lanzl, L. H. J. Am. med. Ass. 1966,

196, 219.14. Young, M. M., Nordin, B. E. C. Proc. R. Soc. Med. 1967, 70, 1137.

increase could be interpreted as the expression of a higher(compensatory) activity of the parathyroid glands afterthe onset of the menopause.The age-distribution data given here are compatible

with a tentative suggestion that there is a pathophysio-logical relationship between the menopause and theincreased frequency of hyperparathyroidism with age inwomen.

The patients were investigated in collaboration with Prof. D.Smeenk, University Hospital, Leiden, and Dr. J. C. Birkenhager,University Hospital, Dijkzigt, Rotterdam.

H. MULLER

Department of Surgery,University Hospital Dijkzigt,Rotterdam 2, Netherlands

Reviews of Books

Surgical Management of Ulcerative ColitisFRANK COUPER WALKER, CH.M., F.R.C.S., F.R.C.S.E., consultant

surgeon, South Teesside group of hospitals. London: Butter-worth. 1969. Pp. 147. 50s.

ULCERATIVE colitis has been put down to a variety of causes,but the plain truth is that we do not know why some people (inthe main, young people) begin for no apparent reason topass blood, mucus, and pus in diarrhoeic stools. Many ofthese patients will die, either from complications of the diseaseor from cancer of the affected large bowel. Conservativetreatment will sometimes bring remission and the periods ofremission may be long, but the only way of achieving a

radical cure is to remove the whole colon and nearly alwaysthe rectum and to leave the patient with a permanent ileostomy.For most people this is a frightening prospect. Yet if livesare to be saved (deaths amount to 500 a year in England andWales) this is the only way to do so. And there are thousandsall over the world who are living testimony that the lives thussaved can be happy and productive. Patients who haveundergone the operation need careful and sympathetic after-treatment until they learn to adjust themselves to theirileostomies. Many of them will find comfort and encourage-ment by joining ileostomy associations where they can meetothers who have had the same experience. The author of thismonograph pays tribute to the pioneer work of Prof. BryanBrooke and his associates at Birmingham who established thatcareful attention to fashioning the ileostomy and teachingpatients how to look after their ileostomy bags could go along way towards dispelling their initial repugnance and fear.This is a splendid guide to the surgical management ofulcerative colitis. It is simply (and therefore well) written,and says only what needs to be said. If there is anything tocriticise it is the poor quality of the illustrations.

The Head and NeckAtlas of Tumor Radiology. GILBERT H. FLETCHER, M.D.; BAO-SHAN JING, M.D., in collaboration with MAx L. M. BooNE, M.D.,THOMAS S. HARLE, M.D., and HOWARD W. HIGHOLT, M.D.,departments of radiotherapy and diagnostic radiology, Universityof Texas, M. D. Anderson Hospital and Tumor Institute atHouston, Texas. Chichester: John Wiley & Sons. Chicago:Year Book Medical Publishers. 1968. Pp. 380. E9 7s.

THIS volume is the first of an Atlas of Tumour Radiologyunder the general editorship of Dr. Philip J. Hodes. Theseries is similar in concept to the Armed Forces Instituteof Pathology’s Atlas of Tumour Pathology. The aim is to com-plete the eleven-volume Atlas by 1972. Books of this typedepend for their success on the quality of the illustrations,and these cannot be faulted-generally speaking they are

excellent and all are clearly labelled with full explanatorylegends. The text is brief, though each section carries a shortintroduction to the radiographic techniques necessary. Thereis also a short description of the clinical significance of tumoursin each area. Besides the X-ray reproductions, there are asmall number of sketches illustrating routes of spread, and

some excellent anatomical drawings essential to the under-standing of the X-rays. The title is slightly misleading sinceintracranial tumours are specifically excluded (these are to beconsidered in a future volume on the Nervous System andthe Eye). This book will be of great use to radiologists at

all stages of training (though if the other ten volumes aresimilarly priced the whole series will be beyond the reach ofthe individual purchaser).

The Influenza Viruses

Virology Monographs Vol. IV. L. HOYLE, director, PublicHealth Laboratory, Northampton, England. Vienna and NewYork: Springer-Verlag. 1968. Pp. 375. S680; DM108;$27.

THIS monograph is one of a series continuing and bringingup to date the well-known Handbook of Virus Research. It isa comprehensive review of all the literature concerning thisvery well studied virus. There are 2500 references, butDr. Hoyle says that even these are not complete. Epidemiologyand vaccination are covered quite well; clinical aspects are

given little space, but all aspects of the structure and basicbiology of the organism are dealt with fully. The author hasspent a lifetime in research on the influenza virus and hassucceeded in mentioning almost everything ever written aboutit. The key findings of each paper are noted, usually withoutcritical or analytical comment, but here and there we findshort passages containing the author’s own, and often uncon-ventional, views on subjects such as the survival of virusesbetween epidemics, and the role of the organism in transferringinformation from one host cell to another and possibly select-ing a new type of respiratory mucosa over the years. Heincludes many half-forgotten earlier papers and has readwidely outside the Anglo-American literature, and even

experienced workers may find references to unfamiliar workon their special interest drawn from, for example, publicationsin Russian. This book will be found useful by anyone workingwith viruses, and especially by those who are interested inbasic aspects of influenza viruses.

New Editions

A Laboratory AfaMMa/ oM .<4&MO?WM/ H&oelig;moglobins.&mdash;2nd ed. ByA Laboratory Manual on Abnormal Haemoglobins.-2nd ed. ByJ. H. P. Jonxis and T. H. J. Huisman. Oxford and Edinburgh:Blackwell Scientific Publications. 1968. Pp. 126. 30s.

Handbook of Communicable Diseases and School Health: A Guidefor Medical Officers of Schools.-14th ed. London : J.&A. Churchill.1969. Pp. 141. 15s.

Low Back Pain Syndrome.-2nd ed. By Rene Cailliet. Oxford:Blackwell Scientific Publications. Philadelphia: F. A. Davis Co.1968. Pp. 134. 28s.

The I.A. T. Manual of Laboratory Animal Practice and Techniques.-2nd ed. Edited by Douglas J. Short and Dorothy P. Woodnott.London: Crosby Lockwood & Son. 1969. Pp. 462. 55s.

A Short Textbook of Surgery.-2nd ed. By Selwyn Taylor andLeonard Cotton. London: English Universities Press. 1968.Pp. 628. 42s. (library edition); 30s. (paperback).