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BOOK REVIEWS

ications. A class of "therapeutic or-

phans" resulted. Although the Fed-

eral Drug Administration has stated

that labeling is not intended "either

to preclude the physician from using

his best judgement in the interest of

the patient, or to impose liability if he

does not follow the package insert,"

some courts have held that the pack-

age insert is prima facie evidence of

the standard of due care. Thus, the

physician using these drugs in chil-

dren may be subject to malpractice

litigation.

Who should read this book? Prob-

ably all institutional review board

members, many of whom I suspect

have no clear idea of their board's

historic development or change, and

certainly all basic or clinical scientists

who delve into human research, as

well as those who control it. As Levinestates, "a competent clinical re-

searcher need never have heard of

Doctors Sydenbam, Bichat, Bernard,

Osler, or even Beecher, not to men-

tion Aristotle, Immanuel Kant, Tal-

cott Parsons or Benjamin Cardozo.

But there are those who are pleased

that they have."

Robert R. Kirby, MD, Col, MC,

USAF

Chairman

Department of Anesthesiology

Wilford Hall USAF Medical Center

Lackland AFB, TX

Chest Physiotherapy inthe Intensive Care Unit,by C. F. Mackenzie, N.

Ciesla, P. C. Imle, and N.

Klemic, Baltimore, Wil-

liams & Wilkins Co., 1981,

260 pp, $23.00.

This text succeeds in providing an

in-depth description of chest physical

therapy services provided at the

Maryland Institute for Emergency

Medical Service Systems. All aspects

of such therapy are amply covered

including a review of respiratory

anatomy; the indications, precautions,

and contraindications of therapy; and

physiologic alterations during and

following therapy. Excellent discus-

sions pertaining to specific patient

populations such as spinal cord inju-

ries and pediatrics are included.

If any weakness exists in this text,

it lies within the limitation of the

patient population discussed. The

vast majority of patients in the au-

thors' institution are men between the

ages of 16 and 30 years. Therefore,

the information given in the text gen-

erally pertains to young, previously

healthy, traumatized patients. This

limits the usefulness of the text withregard to elderly and chronically dis-

eased medical patients. The authors

purposely make no attempt to relate

the therapies as carried out in their

institution to other accepted treat-

ment regimens popularized in other

patient populations.

The text is well written and the

illustrations and chest radiograms add

greatly to its instructional value. We

feel this book is of benefit to all

professionals concerned with the res-

piratory aspects of critically il l pa-

tients even though it deals exclusivelywith physical therapy modalities as

applied to the respiratory care patient.

Pamela 0.Harman, RPT

Assistant Director

Respiratory Physical Therapy

Northwestern Memorial

Barry A. Shapiro, MD

Professor of Clinical Anesthesia

Director

Division of Respiratory

Department of Anesthesia

Northwestern University

Chicago, IL

Hospital

Critical Care

Medical School

BOOKS RECEIVED

Handbook of Critical Care, Second Edi-

tion, edited by 1.L. Berk and J. E. Sampli-

ner, Boston, Little, Brown and Co, 1982,

688 pp, $24.50.

Cardiac Anesthesia, by T. J. Conahan,

Menlo Park, CA, Addison-Wesley Pub-

lishing Co, Inc, 1982, 340 pp, $29.95.

Respiratory Failure in the Child, edited

by G. A . Gregory, New York, Churchill

Livingstone, Inc, 1981, 205 pp, $32.50.

Obstetric Anesthesia: The Complicated

Patient, by F. M . James and A . 5. Wheeler,

Philadelphia, FA Davis Co, 1982, 346 pp,$40.00.

Persistent Pain: Modern Methods of

Treatment, Volume 3, edited by S.Lipton

and J. Miles. New York, Gmne & Stratton,

1981, 260 pp, $48.00.

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NESTHESIA AND ANALGESIA

Vol61, No 5, May 1982