Scoliosis

The Chromosome Disorders. An Introduction for Clinicians. By G. H. VALENTINE. (Pp. x + 129; 74 figures. 25s.) London: William Heinemann Medical Books. 1966. Diagnostic procedures become progressively more sophisticated and complex, and the older clinician increasingly more removed from the heart of things, and is almost reduced to reading the conclusions of reports without fully understanding the substance. Cytogenetics, the working of the cell, the genetic code, the details of all these are increasingly difficult to follow and not made easier by the growth of specialist jargon. Dr. Valentine, a clinical paediatrician, addresses this valuable little book to his colleagues and calls it a story book; and he writes, indeed, in a simple, gay language which helps to clarify a lot of the mysteries of cytogenetics. Of necessity he has practised meiosis and gallops gaily through the cell, its chromosomes, the happenings of cell division, and the abnormalities that stem from faulty division, all in 28 pages. He then slips in an invaluable chapter on dermal ridge patterns and dermatoglyphics, before spending, in chapter 5, over a quarter of the whole book on mongolism. This is an excellent arrangement. Every paediatrician knows mongolism backwards and so the author can concentrate all the aberrations of chromosomes and fingerprints in illustration ofthe whole cytogenetic story. In this chapter there is perhaps just one important point over which at least some of his colleagues may disagree. Dr. Valentine appears to say that he would tell her immediately when 'faced with a mother with a newborn mongol baby'. He also recommends that when a mongol is born to a woman below 35 years chromosome studies are mandatory: the matter is, he says, too important. Perhaps he is right, though it may not always be possible. Ten pages go to trisomies D (13-15) and E (16-18) and to 'cat cry'. The remaining 30 pages are given over to aberrations of the sex chromosomes. Here the author becomes particularly happy, and amongst other things points out the overriding importance of the Y chromosome, the timely intervention of which decide the gonads to develop into testes, which, in the nick of time, persuade the genitalia to develop the masculine configuration by which phenotypical man is recognizable at a glance. This little book will be a valuable help to all practising physicians and medical students. It has several useful diagrams, adequate photographs, and is well bound.