Clinical Practice and Physiology of Artificial Respiration

From its title, the reader may expect a great deal more than he wlll find in this book. Its slenderness, compared with the enormity of the subject of its title, may first give him cause to wonder. There is a good coverage of the management of acute poliomyelitis and acute polyneuritis; this is to be anticipated, for the unit concerned is primarily neurologically orientated. The management of many other conditions in which artificial respiration forms an important aspect of treatment is covered superftclally or barely referred to at all. The use of artificial respiration in patients with acute-on-chronic lung disease (one of the commonest indications for the use of artificial ventilation) receives bareiy half a page of text, and even this half-page paints a picture so gloomy as to be unrealistic. It is irritating to find that the section devoted to the physiological principles underlying artificial respiration follows that devoted to the technical aspects of its practice. Here, par excellence, is a topic that alIows therapeutic practice to fiow naturally from the physioiogicai principles involved; indeed, historicalIy, the practice of artificial ventilation of the lungs owes much to the physiological laboratory. The present format perpetuates the unfortunate situation in which physiological principles are permitted to "explain" or "justify" therapeutic practice, rather than acting as a natural basis for them.