Preventive Medicine in Medical Care

PREVENTIVE MEDICINE IN MEDICAL CARE. By Kurt Schwarz. (Pp 216. £2.50). London: H. K. Lewis, 1970. THE author of this book combines his appointment as Senior Lecturer in Preventive Medicine and Public Health at the University of Leeds with those of Assistant Medical Officer to the City of Leeds and Consultant Physician to the United Leeds Hospitals. By virtue of these appointments he is in the unique position of being able to take a broad view of the epidemiology of infectious and non-infectious disease from both the hospital and clinical and the community and social standpoints. The first edition comes at an opportune time when much emphasis is being placed on the social and preventive aspects of disease and on the interrelationship beween he environment and the health of its citizens. There is justification for bringing a greater content of medical care to the patient in his normal home envinorment. On reading this volume one is continually reminded of the importance of health education and preventive medicine generally, and as disciplines which will undoubtedly assume greater importance in the "unified" health services of the future. The author lays stress on this approach by subdividing chapters under such headings as "pre-symptomatic diagnosis", "primary and secondary prevention", "early diagnosis" and "public health aspects". He further emphasises the theme in his reference to the importance of "screening" in medical care, in the surveillance of "at risk" groups in the community and in the emphasis on "specific projects" with public co-operation, e.g. in the fields of cancer diagnosis and accident prevention. A criticism of this book could be that in the short space of just over 200 pages the author attempts too much. He has not set out to write a textbook of clinical medicine (there is often insufficient clinical data to make an accurate diagnosis), neither is this a treatise on social medicine but it is a valiant attempt to wed the two and almost succeeds in doing so. The book certainly fulfils the author's claim to be "a practical guide to the practice of preventive medicine and the application of preventive medical procedures to individuals and the community". In addition to being a valuable guide for senior undergraduate and post graduate students it offers to doctors in public health, occupational health and general practice perspectives in priorities for the promotion of community health and for the prevention and control of specific disorders. For more advanced students who wish to expand their knowledge by additional reading a list of relevant literature is given at the end of chapters; in. all there are forty eight recommended references for further study. In this interesting and very readable book the author by combining the clinical and the social has introduced a new trend which will no doubt be further developed by authors in the future, a future which promises not only many changes in health service structure but in the whole field of undergraduate and post graduate medical education. J.McA.T.