Thirst

hypothermia is an adjunct, purely a "metabolic crutch, providing additional time in which to pursue the specific treatment, whether medical or surgical." The pathophysiology of the major congenital and acquired cardiac lesions is discussed in terms of the applicability and usefulness of hypothermia. In addition, the author discusses and evaluates the varied clinical situations in which hypothermia has been used in general surgery, medicine, neuro-surgery, shock and trauma, obstetrics, and pediatrics. Included is a very timely and comprehensive discussion of clinical situations in which hypo-thermia has been tried and found to be contraindicated, or unnecessary. The chapter on complications represents a synthesis of present-day thoughts on what complications are in fact secondary to the hypothermia itself. The author makes the important distinction between the complications of hypothermia and the ill effects of inadequate hypothermia. Included is a chapter concerning the methods of inducing hypothermia, and a chapter concerning its management. The final chapter is a somewhat speculative and imaginative summary of the important roles which hypo-thermia could well assume in the future. The book is 250 pages long, contains appropriate charts, graphs, and tables, and each chapter has an excellent and complete list of references, It is a concise, accurate, and realistic assessment of hypothermia in its present day roles in medicine. For the student of hypothermia, it is an excellent type. For the more advanced reader, it represents a comprehensive summary as well as a complete reference source. It consists of 27 papers, most of them followed by a discussion. The emphasis of the symposium is on investigations of thirst as a psychological phenomenon rather than as a symptom of change in the complex physiological mechanisms concerned with maintenance of the organism's volume and tonicity in a dessicating environment. Twelve of the papers presented deal with studies on the effect of various central nervous system lesions on water intake by experimental animals. Several of the other papers cover such topics as, "Some effects of Restricted Water Intake On Consummatory Behavior of the Rat", "Theory and Research on the Effects of Water Deprivation on Random Activity in the Rat", and "Thirst as a Determinant of Reinforcement." The coverage of clinical problems of salt and water metabolism was meager and incomplete. Nowhere in the volume were the recent advances in our knowledge of the renal concentrating mechanism, the most important mechanism of water conservation in mammals.