Cortisone Therapy

Ttiis is a useful book, in which the place of cortisone and other steroid drugs in the treatment of the rheumatic diseases is reviewed. The book falls naturally into two parts. The first section conisists of five chapters, and is concerned with the use of cortisone in rheumatoid arthritis. The second section consists of two chapters, the first of which decribes the general use of cortisone in diseases other than rheumatoid arthritis, while the second discusses miscellaneous topics related to cortisone therapy such as the probleriis of drug production, therapeutic trials, mode of action of steroid drugs, and prospects for the future. Finally, there are several appendices, in one of which-.Dr. J. G. Bearn, of the Anatomy Department of the Middlesex Hospital, London, describes the anatomy and technique of intra-articular, and soft tissue injections of cortisone. The best section is undoubtedly the first part, where Dr. Glyn describes the value, methods, indications, and limitations of cortisone therapy in rheumatoid arthritis. It is now ten years since Hench first employed cortisone in this condition, but there is as yet no unanimity among those best qualified to speak. about its merits or demerits. Nevertheless, Dr. Glyn has tackled the problem bravely and with success, and has provided a helpful guide for those inexperienced in this new treatmcnt. Much too of what he has to say is of value to the expert, and few will fail to profit from the balanced and comprehensive survey of this difficult field of modern therapeutics. Adequate stress has been laid on the dangers of indiscriminate use of cortisone in rheumatoid arthritis and the complications of treatment are fully discussed. The section describing the pre-treatment "briefing" of the patient is most practical, for all patients on cortisone must know something of the problems to be faced, and this knowledge helps to prevent undue disappointmenlts later if success is not achieved. The second section is less comprehensive than the first because of condensation, but it provides a good summary of the use of cortisone in a wide variety of diseases, including such collagen disorders as systemic lupus eryth^matosis, polyarteritis nodosa and dermato-myositis, and the allergic states. This book will be of value to all physicians and surgeons anxious to bring themselves up to date witlh cortisone therapy. MOST of this report is of necessity occupied by somewhat formal and factual details of the various research units, groups, and individuals …