Fundamentals of Internal Medicine

FUNDAMENTALS OF INTERNAL MEDICINE. By Wallace M. Yater. 3d ed. New York, Appleton-Century-Crofts, Inc., 1949. xviii + 1451 pp. $12.00. A textbook of medicine is usually intended to orient the beginning student in the fundamentals of the broad field of internal medicine. This book admirably fulfils this concept. The style and format make for easy reading. This edition has been enlarged from the previous one. Also, it has been generally brought up to date with recent advances, especially in the field of therapeutics. It seemed to the reviewer that none of the sections could be considered "weak" or especially inadequate for their purpose. The sections on heart disease, electrocardiography, and the endocrine glands were unusually well handled, authoritative, and sufficiently detailed. Also, it was surprising to find such an adequate section on the common dermatoses. Chapters on antibiotics and chemotherapeutic agents and on inhalation therapy have been added to this edition. The section on symptomatic and supportive treatment seemed pertinent since it involves a subject too often neglected in formal teaching. The book is not without minor errors and misleading statements. Slight errors were present in the formulae for calculation of the mean corpuscular volume and mean corpuscular hemoglobin. The term "achrestic" was mispelled. Also, the sections on acidosis and alkalosis were presented too glibly for real accuracy. One was almost led to believe that the determination of the serum pH was necessary to make a diagnosis of acidosis or alkalosis. Little consideration was given to acidosis associated with high nor to alkalosis with low serum bicarbonate content. Diabetes mellitus is bluntly described as a disease wherein carbohydrate utilization is impaired because of an insufficient supply of insulin. Present knowledge would not warrant such a didactic definition. Occasionally, dubious statements are made; for example, that patients with "primary hypotension" are "especially vulnerable to pneumonia and less serious respiratory infections." Undoubtedly this statement was based on a personal impression rather than a documented fact. The text is intended to give practical considerations to the essentials of general practice. While medicine can be, and frequently is, practiced by rules of thumb and while positive statements may be reassuring to the student, the omission of controversial and unsolved problems neither stimulates nor inspires the reader. While the omission can be cited as a definite criticism, this is not the only textbook of medicine to fall short in this regard. In any event, it is still clear that Dr. Yater has included more sound information than is usually found in one volume. The diagnostic charts, tables, and illustrations are well conceived and selected. For the beginning student and general practitioner the text will find wide use.