Reaction to Injury

DIFFERENTIAL DIAGNOSIS. By H. T. Hyman, M.D. Second edition. (Pp. xxix t 716. 55s.) London: Lippincott, 1953. THIS is an unusual book and of a type which will be strange to British readers. It starts with a section in which are listed 1,585 symptoms and signs. Reference to any one of these directs the reader to some one of the 232 divisions of differential diagnosis, alphabetically arranged. These divisions describe the various causes of the symptoms, give diagnostic criteria and brief details of each clinical syndrome, including therapeutic tests and suggestions for treatment. According to the author, the book has been prepared for office and bedside use by practising physicians for specialists retaining a broad interest in clinical medicine and for those undergraduates, interns, and residents who aspire to creative careers in private and institutional practice. While the reviewer would not quarrel with its value for experienced practitioners, he does not consider that undergraduates or recently qualified doctors would find this a useful or helpful presentation of diagnosis in medicine. For the inexperienced, the detail is too brief to be successful, and such briefness may carry its own dangers. Much of the book, however, will be of practical help to the experienced doctor. Many of the sections contain valuable suggestions and are well written, although in a brief, staccato style. A long section of ninety pages on occupational hazards and their diagnostic features requires radical pruning, if the real dangers of industry are not to be buried in a welter of irrelevant details. In summary, therefore, this is an unusual and interesting presentation of differential diagnosis, best suited for brief reference by experienced doctors. It is well printed and produced, but, unfortunately, the price is high. D. A. D. M.