Disorders of Voluntary Muscle

L)UCHENNE of Bouiogne nearly one hundred years ago realised that in order to understand and treat muscle disease the clinician must himself be conversant with pathology and electrodiagnosis. Many of the diseases of muscle classified by the nineteenth-century neurologists remain mysterious in all but the name, similar then as now. Yet exciting advances in the basic problems of muscle disorders have accumulated in the past ten years. The electron microscope has uncovered the hitherto hidden ultrastructure of the muscle cell. Enzyme studies have led to the diagnosis of muscular dystrophy before it is clinically apparent. A biochemical defect in one rare muscle disease is now well established. Electromyography is a tool for the clinician and recent biopsy techniques have brought the pathologist and the physician in close cooperation. This book edited by Dr. John Walton attempts to bring to the clinician, be he general ph!ysician, paediatrician or neurologist, a concise, authoritative and critical view of all these aspects. There are four sections (on anatomy and physiology, pathology, clinical problems in muscle disease and electrodiagnosis) to which twenty-four experts, including the editor, have contributed chapters. The book is an unqualified success. Despite the varying styles to be expected when contributors differ in discipline, there is a delicate balance between the scientific and the clinical, the proven and the speculative. It is a well-produced book with very clear illustrations and the bibliography is numerous and well chosen. For many it will be a good book for reference. To the clinician who has the care of patients it will give invaluable information. The postgraduate student will find some of the chapters on clinical problems well worthy of study. To all who believe that the next ten years will bring a real breakthrough in the treatment of muscle diseases the book will be a guide to the manner in which this may be brought about. THE author has had experience both as a general surgical registrar and as an orthopaedic registrar at two London teaching hospitals. He points out that teaching hospitals in the centre of big cities receive relatively few miajor casualties from road accidents. Medical students can qualify with little teaching in traumatic work and yet may find themselves in a casualty department confronted with a severely injured patient, when they have to act promptly on their own initiative. While the information in this small book can all be gleaned from any …