Medical Acid-base Balance

an increase in the number of poisonings occurring in the province or from an increase in the number of enquiries with no change in the number of poisonings. (ii) there was an increase in 1976 in the number of prescriptions dispensed and therefore an increase in the number of drugs consumed. (iii) the increase in enquiries about poisoning in children, if it reflects an increase in actual poisoning, may indicate greater carelessness with drugs and household chemicals by parents. THIS little book is an honest attempt by an experienced clinical biochemist to explain the principles of acid-base balance to medical students, and to postgraduates who must needs refresh their memory. There are few clinicians whose field of practice covers all aspects of the possible acid-base disturbances-most of us adapt to our sector of knowledge and focus on a few useful landmarks. I found the book relatively unhelpful in revealing the foundations of those particular landmarks visible to me but it was helpful in coming back to first principles for the whole subject. It is a pity that more direct clinical practice is not included, such as a house physician's practical guide towards correction of acid-base imbalance. Diabetic ketoacidosis, the major metabolic acidosis with considerable respiratory and renal components, is not mentioned at all in the index and I could find the words only once in the text. On the other hand I learnt a lot about the difficulties of measuring plasma bicarbonate. The chief value of the book, to either an informed medical student or an interested postgraduate will be in the discussions in the appendices of the several recent techniques for determination of pH, pCO2 and pO2. The several complex monograms and other aids to calculation are handled from an unbiased viewpoint. These sections are practical and informative , and helpful to the clinician in his contact with laboratory staff. The mathematical theoretician will like the numerous formulae and the logical structure of the book: I would prefer preclinical medical students to learn this subject from a more practical standpoint, but for a source to consult with regard to basic principles this book is more useful than the average pre-clinical textbook.