By Polly E. Parsons MD, Jeanine P. Wiener-Kronish MD

Following the profitable question-and-answer structure of The secrets and techniques sequence, this publication offers an interesting evaluation of present scientific wisdom of severe care. It covers the spectrum of serious care subject matters, from pathophysiology to in depth care administration. The e-book is a wonderful technique to organize for examinations, no matter if oral or written, and is additionally a truly precious overview for practitioners

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But there remains a tendency to attribute backache to some radiological or other abnormality which in fact is coincidental. When a middle-age backache victim is X-rayed he may be found to have calcified spurs on some of his vertebrae. These spurs have probably no connection with the backache, but the patient may be informed that he has 'arthritis of the spine·, and thereafter take it for granted that this is 30 THE STATE OF MEDICINE the cause of his backache. The spine X-rays of old people frequently show wedging of one or more vertebrae resulting from crush fractures in the past.

The individual doctor can do nothing to achieve that goal. Many doctors spend a lot of time in urging people to eat less sweets, starches, and fats. But they give this advice to patients who are already fat. And their success rate in persuading people to make a life-long reduction in their food intake is very small. Indeed, although obesity is eminently curable in the sense that if patients will only adopt the recommended treatment their weight will fall to normal and remain normal, we all know that in practice there are few more hopeless problems than the woman who has been grossly overweight for years.

However frequent are the attacks, and however long they persist, there never develops demonstrable disease of the cerebral arteries. The immediate basis of epilepsy is said to be a disturbance in the chemico-electrical activity of the brain, though statements of this kind are of no help in understanding the nature of epilepsy. Much epilepsy is idiopathic and however long the attacks continue, the brain appears normal. Other epilepsy is symptomatic and clearly related to some disease affecting the brain.

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