Problems in Peripheral Vascular Disease

THIS is the English edition (by Dr Gunn) of a detailed, step-by-step instruction manual for the full physical examination of patients. It is the product of Dr Lordwick and members of the "Skills Laboratory" of the Medical School in the University of Limburg, Holland. The basic aim is that students should acquire the medical skills of patient examination in a systematic and reasonably standardized manner. This is an important book, being one of the few publications that provides a reliable reference to the student, reinforcing introductory clinical teaching. Nobody would deny the importance of the initial clinical methods course at Queen's. Yet teachers and students are acutely conscious of the unevenness with which such methods are learnt or are practiced, given the pressure of work on various units and the number of students concentrated in teaching hospitals. A basic concept of this book is that the acquisition of medical skills should occur with minimal dependence on teachers and patients. The book does convey to students as exactly as possible how a given examination should be carried out. Each examination has a heading stating its purpose. The procedure to be followed is then itemised, amply illustrated by photographs and diagrams. The student is kept to the task of examination as considerations of pathology and differential diagnosis are not dealt with in the text but the opportunity for such discussion is indicated. The subtitle-"An Atlas for General Practice" was at first intriguing especially as the myth that general practitioners do not examine their patients is still abroad, though only with a fraction of the force it once had. Indeed the heresy of one generation,-that of general practitioners teaching clinical methods, could become the practice of the next generation. This is particularly pertinent considering the numbers of ambulant and chronically ill patients available in general practice and the amount of time students properly spend there. Increasing use of this book, despite the price of the hardback form of almost £20.00 would ensure that such time was well spent. THIS rather elegant book emerges as a further publication amidst a proliferating mass of literature and volumes which reflect the rapid burgeoning of vascular surgery as a specialized discipline. As the author himself acknowledges in the preface, he has relied heavily on well-established tomes on arterial and venous disease which are in general use. As one bo6k in a 'problem series' designed to help the …