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BOOK REVIEWS Sir Thomas Lewis: Pioneer Cardiologist and Clinical Scientist. By Arthur Hollman. London: Springer, 1997. $75.00. Some individuals have societal and scientific impacts which transcend the importance of their excellent research. This truism is applicable to Sir Thomas Lewis (1881-1945) , and Arthur Hollman's recendy published biography, detailing his life and work, documents this assertion. The book is carefully crafted and reflects the many years Dr. Hollman labored at his chosen task. As outlined in the Preface, Dr. Hollman was one of the last students studying with Dr. Lewis. Apparently he seriously began to collect information on the life a decade after Lewis' death, with the book now appearing approximately 50 years later. Dr. Hollman's knowledge of the man was clearly enriched and bolstered by the meticulous study of Lewis' books, papers, and private and previously published letters. Sir Thomas' zest for life, his scientific curiosity, and his ability to design and implement research projects are clearly portrayed. His contributions to heart disease, peripheral vascular disease, and pain mechanisms are succinctly recorded. From the springboard of knowledge derived from Mackenzie's simple recording devices for the study of the pulse, he was launched into basic electrocardiographic work. In this venture he had encouragement from Einthoven in Leiden. Two of Lewis' monumental achievements were the clear explanation of the nature of atrial fibrillation and the introduction of a near-modern method of measuring excitation conduction times in the myocardium, particularly of the atria. The subtitle Dr. Hollman chose for the book, "Pioneer Cardiologist and Clinical Scientist" eptiomizes the theme of the volume, as Dr. Krikler points out in the Foreword. Scientists not specifically interested in cardiology might, I believe, still enjoy perusing the book, focusing on the sections discussing the problems of research support generally and in England particularly, and describing Lewis' crusade to establish the entity of the clinical investigator, a breed apart from the clinical practitioner. I expect too, that the general scientist would have a special interest in Appendix 4, a letter written by Lewis and reproduced in full, which clearly outlines his perspective on research in medicine. The sections are entitled "Functions of the Research Worker"; "Present System and Its Consequences"; and "Needs of the Worker." The British Medical Research Council from its beginnings had a bias tending to revere pure science and be disdainful of clinical science, so the Lewis clash with its secretary, Fletcher, was foreordained. The biography will have a narrow special fascination for those interested in the history of cardiology and the personality of Sir Thomas Lewis (we could now be preparing to celebrate the approaching centennial of clinical electrocardiograPermission to reprint a book review printed in this section may be obtained only from the author. Perspectives in Biology and Medicine, 40, 4 ¦ Summer 1997 | 619 phy) . Additionally, it will be a source of information for those engaged in any study of (1) the development of clinical investigation; (2) the conflict of interest between the intensely focused research physician and the care-giver physician; (3) the old conventional attitudes towards assumptions of consent without the patient receiving detailed information; (4) a paternalism with benevolence; and (5) selfexperimentation . Hollman has thus gathered an excellent background of information for future historians. Implicit in the story of Lewis' life is the illustration of how a leader in thought and deed can be partly a prisoner of his own time, viz. Lewis' inability in his latter years to recognize the value of the technological breakthrough of cardiac catheterization. However, even in his last years, Lewis' qualities as a superb inspired teacher remained, as Dr. Hollman points out; his last book (1945) was entitled Exercises in Human Physiology: Preparation for Clinical Work. Any teacher might well benefit from review and criticism of this little book, Lewis' breadth of interest in basic mechanisms and measurements being so impressive therein. Dr. Hollman discusses charitably but firmly some errors in Lewis' teaching, such as the Nomenclature of Bundle Branch Block; the personality clash and differences in research vision with Dr. Craib (of the electric doublet theory fame); and the transient estrangement with Sir James Mackenzie attendant upon the rejection of the latter's paper concerning the effect...

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