CUNNINGHAM'S TEXTBOOK OF ANATOMY

THIS excellent little book is unusual in several aspects. At the outset it strikes a welcome change in the title which emphasizes the fact that the statutory venereal diseases are not the only conditions dealt with by the physician who works in this branch of medicine. After dealing with anatomical details, history taking and examination of the patient (the latter in particular giving much valuable and sane advice) the author spends some time in discussing the public health aspects, medico-legal management, sociological and psychological background associated with sexually transmitted diseases. These chapters contain much valuable material often forgotten or neglected by those casually handling patients affected with these conditions. Only after dealing with these important questions does the author turn to the clinical aspects of the sexually transmitted infections. A valuable and interesting chapter, including pathology, immunity, aetiology and the history of syphillis, is followed by an excellent account of the serological tests for syphillis and their interpretation. The chapter on the pathology, epidemiology and diagnosis of gonorrhoea is likewise valuable. The clinical descriptions of the various conditions are concise and good and include not only a description of the commonly found sexually transmitted infections but also treponematosis and endemic syphilis and a chapter on "tropical diseases affecting the genitalia". A welcome warning is given against indiscriminate treatment of congenital syphilis on page 123 and "blunderbuss" therapy of gonorrhoea on page 146, whilst the value of repeated courses of treatment in cardiovascular syphilis confirms one's own clinical experience: guarded prognosis following surgical treatment of aneurysm of the aorta and aortic valvular incompetence is stated on page 109. A valuable bibliography is given for further reading at the end of each chapter. His emphasis on the rarity of gonococcal arthritis on pages 124 and 140 would be questioned in this school and the impression is given on page 141 that gonococcal infection of the conjunctiva occurs only in adults and whilst admittedly extremely rare, it is important to remember that accidental infection of the conjunctiva can occur in children also. Not all venereologists will agree that a three month follow-up after the use of broad spectrum antibiotics is sufficient.