Microbes, Man and Animals: The Natural History of Microbial Interactions (review)

BOOK REVIEW Microbes, Man and Animab: The Natural Hütory ofMicrobial Interactions. By Alan H. Linton and Others. New York: John Wiley & Sons, 1982. Pp. 342. $47.95. Among the innovations in American medical school education during the late 1960s dirough the mid 1970s were courses for the preclinical years that did not adhere to the sometimes arbitrary divisions between the basic sciences but instead focused on clinical problems and integrated material from a variety of disciplines. During that period, there was also an emphasis on placing patients and their diseases within a larger social context. Unfortunately, many of the innovations of that time have not found a permanent place in medical school curricula. It is encouraging, therefore, to read Microbes, Men and Animak by Dr. A. H. Linton and his colleagues at the University of Bristol in England, as it embodies many of those educational concerns. Based on a course taught by Linton to honors microbiology undergraduates, it attempts to explain host-microbial interactions and the infectious diseases that such interactions produce by integrating aspects of immunology, microbiology, and epidemiology. Not attempting a comprehensive overview of eidier infectious disease or microbiology , Linton has instead chosen to discuss selected topics that he feels elucidate basic principles of microbial pathogenesis and disease transmission. The first third of the book is devoted to describing die interactions that occur between individual hosts and microbial agents and has chapters that include discussions of host defenses, mechanisms of bacterial pathogenesis focusing on exotoxins and endotoxins, and mechanisms of viral pathogenesis. The second part emphasizes general concepts of epidemiology and control of infections and includes chapters on immunization, chemotherapy, and hospital-acquired infection . The last third of the book attempts to illustrate the principles discussed in the first two parts by focusing on specific infections, including the zoonoses, food-, water-, and arthropod-borne infections, and influenza and gonorrhea. The authors' obvious enthusiasm for the subject is evident throughout the text, and die book is replete with historical references and allusions to the veterinary experience that Linton is particularly well acquainted with. This, along with efforts to sustain a common theme throughout die book, makes it a highly readable text. On the other hand, in an effort to sustain that common theme and perhaps to achieve the conciseness which is in part one of die virtues of the book, the subdeties and uncertainties surrounding much ofthe material discussed seem to Permission to reprint a book review printed in this section may be obtained only from the author. 488 Book Review be deemphasized. This is particularly evident to me in those clinical areas that I am most familiar with, where examples chosen to illuminate particular points are frequently misleading and oftenjust wrong. Among the more obvious examples are the statements that patients widi infectious hepatitis are "isolated and treated in special isolation units in hospitals," that in the Indian subcontinent "cholera is now a rarity at the present time," a reference to adenovirus as the agent of the common cold, a comment that prophylactic antibiotics prior to gut surgery are ". . . now considered a highly dangerous procedure," a comment that is actually contradicted in a subsequent chapter, and, with regard to cephalosporin antibiotics , that "bacteria rapidly develop resistance to them." Other clinical misconceptions abound, but perhaps the most inexplicable is in the chapter on gonorrhea, where it is stated that "herd immunity could be increased by a return to more stable sex partnership patterns." This book serves a number of functions that I consider quite important. It provides a brief but stimulating discussion of the factors that govern hostmicrobe interaction on the cellular and individual level. Perhaps more importandy , it provides a historical and social context in which to consider the diseases discussed. As such it would be an important and useful text for upper-level undergraduates in a seminar course or as an adjunct to a standard microbiology test in a course for medical or veterinary students. Had the authors been more restrained and exacting in some oftheir statements, I could have recommended the book with more endiusiasm. Michael Bennish Department ofPediatrics WyUr Children's Hospital 950 East 59th Street, Chicago, Illinois 60637 Perspectives in Biology andMedicine, 27, 3...