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Copeman's textbook of the rheumatic diseases. J. T. Scott Fifth Edition. Edinburgh London And New York Churchill Livingstone 1978. 1080 Pages. Price65.00

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BOOK REVIEWS
Copeman’s Textbook 0 , the Rheumatic Diseases. J . T. Scott. Fifth Edition. Edinburgh,
London and New Y ork, Churchill Livingstone,
1978. I080 pages. Price: $65.00
This is the magnum opus of British rheumatology. It is almost too great in weighing close to ‘12 stone*,
to the local version of which it feels comparable after
lying awhile on the lap. The bulk owes to its ambitions
of covering the entire field of rheumatology. There is
emphasis on immunology, much being of the lookingforward variety. For example, “The Role of Microbial
Infection in Rheumatic Diseases” fills 31 pages with
evidence bearing on associations, largely theoretical, between microbial infection and rheumatic disease. There
are 1 1 sections and 46 chapters.
Section I, The Rheumatic Diseases, includes
chapters on History, Nomenclature and Classification,
Epidemiology, Pain, Structure and Function of Connective Tissue, and Inflammation. Section I1 comprises
4 chapters dealing with Immunology, Section 111 Rheumatoid Arthritis, IV Treatment of Rheumatoid Arthritis, V Seronegative Spondarthritis, VI Osteoarthrosis,
VII Metabolic Disease, VIII Other Forms of Arthritis,
IX Inflammatory Disorders of Connective Tissue, X
Non-Articular Rheumatic Disease, and Section XI Clinical and Laboratory Techniques. The latter includes
History-Taking and Clinical Examinations, Clinical Trials and Therapeutic Evaluation, Arthroscopy, etc., Injection Techniques, Electrodiagnosis in the Rheumatic
Diseases, and Serological Tests.
Some of the minor chapters will doubtless be
surplus to the needs of rheumatologists or anyone wanting to read through the book systematically, and there is
an occasional lapse into pedantry, e.g.,
N on-conclusive reasoning includes not only the
traditional foundation for scientific thinking, inductive argument, but also such forms as argument
by analogy and interpretative argument. An element of circularity is difficult to avoid, as is evident
in the justification for many statistical procedures.
The clinical material is bare-boned compared to
this rotund example quoted from a free-wheeling and
fascinating chapter on epidemiology, and some rheumatic disorders (or concepts) are dealt with in-
* 6 pounds
adequately, if at all. Mixed connective tissue disease is
dismissed in a line or two, and polyarteritis and temporal arteritis are the only forms of vasculitis explored
in any detail. As if to highlight British rheumatology’s
deliverance from physical medicine, fibrositis is reduced
from a chapter in the Fourth Edition to “an old concept” in this one. An elegant discussion of pain appears
to be its successor. The chapter on drug treatment of
rheumatoid arthritis is, to my taste, somewhat sour in its
emphasis on therapeutic misadventures.
With few exceptions, the book is authoritative
and well written; it is enlivened often by the inimitable
British style. Each section has its excellent parts, and the
whole of Sections 111, V, VI, VII, and VIII are very
good, discounting the omissions. The photographs are
usually appropriate and reproduced clearly. (There is no
chapter on radiology.) There are thousands of references, now identified by title as well as source.
The heirs to Samuel Johnson’s dicta will understand that to praise everything is to praise nothing.
Taken as a whole, the book is deserving of a place in any
medical reference library. It is probably the best rheumatology reference work now available.
GENEV. BALL,M.D.
Division of Clinical Immunology and
R h e u m tology
University of Alabama in Birmingham
Ankylosing Spondylitis: Discussions in Patient
Management. Andrei Calin and James F. Fries.
Garden City, New York, Medical Examination
Publishing Co., 1978. I 1 7 pages.
The title of this monograph is misleading and
tends to undermine its usefulness. Drs. Calin and Fries
have actually briefly, but comprehensively, reviewed
current concepts of the seronegative spondylarthritides
in general and ankylosing spondylitis in particular.
Chapters summarize the historical development of these
present concepts, diagnostic criteria, classification, genetics, clinical assessment, systemic features, radiology,
and management. There are no “discussions in patient
management” included, but several illustrative case reports are appended.
The authors rely heavily on their own experience
and studies and perhaps overemphasize such observations as the possible 20% prevalence of ankylpsing
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london, livingstone, churchill, price65, 1978, edinburgh, 1080, scott, disease, new, page, edition, york, rheumatic, fifty, textbook, copeman
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