Diabetes: With a Chapter on Hypoglycemia ed. by Robert H. Williams (review)

BOOK REVIEWS Diabetes: With a Chapter on Hypoglycemia. Edited by Robert H. Williams. New York: Paul B. Hoeber, Inc., i960. Pp. xvi+793. $20.00. For many years following the discovery ofinsulin the pace ofresearch in diabetes and related metabolic problems was, compared to the last decade, slow. True, this period was punctuated by important advances, such as the distinguished work ofHoussay and others on endocrinology ofexperimental diabetes, the delineation ofsome ofthe grosser aspects ofinsulinaction, the discovery ofthe diabetogeniceffects ofalloxan, and the development ofclinically useful modified insulins. But progress in general was notremarkable. There was a dearth ofnew ideas and methods for advancing understanding ofthe disease in the patient and its management. Many usefulclinicalstatistics were gathered, but remarkably little of depth and significance was gained. Meanwhile, the increasing number of prolonged survivals made possible by insulin added another dimension to the problem of degenerative complications oflong-term diabetes. In recent years this picture has changed. Now diabetes occupies a conspicuous position in the world of investigative medicine. Partly this reflects the general growth and development ofmedical research, and partly it is the result ofspecific stimuli to diabetes research, such as the development ofthe oral hypoglycemic agents. A new generation of able clinical investigators hasemerged, giving newlife to afield once attractive to few students ofdisease. The future holds great promise. This volume is an excellent reflection ofthe modern scene in investigative and clinical diabetes. The editor, Dr. Robert H. Williams, has selected and integrated the work of fifty-four authors in forty-nine chapters with good co-ordination and remarkably little duplication of material. Most of the authors are laboratory or clinical students of the disease who are currently making contributions ofvarying importance to knowledge of diabetes. Approximately halfthe volume is devoted to recent fundamental physiological and chemical advances and halfto clinical topics. Appropriately, in the opening chapter Dr. Charles H. Best sets the stage with a thrilling panoramic view of epochs in the growth of knowledge of diabetes, starting with the earliest written records ofthe subject. From this point on, the volume is thoroughly modem in its approach to diabetes. One criterion ofthe newness ofmost ofthe material is the fact that a majority ofthe references date back no further than six or seven years. It is inevitable that in different chapters the specific gravity ofthe material (defined as significance per unit of space occupied) should vary widely and that there should be unevenness of clarity and forceful exposition. However, these qualities are inherent in 266 Book Reviews Perspectives in Biology and Medicine · Winter 1961 multiple-author volumes dealing with many facets ofa disease and detract little from the over-all value ofthe book. It is gratifying that toe work is rounded out in a concluding chapter by the editor on hypoglycemia. The varied materialin the book will appeal to an audience with a broad range ofinterests in diabetes, from the purely clinical to the purely investigative. For readers with investigative interests, frequent revisions will be necessary. Appreciation of the entire volume requires at least moderate scientific sophistication in the field of diabetes; but this can be said of any broadly conceived medical work because, after all, modern medicine is sophisticated. Randall G. Spragub Mayo Clinic Stress and Cellular Function. By H. Laborit. Philadelphia: J. B. Lippincott Co., 1959. Pp. CÌ+2J5. $7.50. The author, undoubtedly the leading proponent of artificial hibernation as a therapeutic procedure, outlines the theoretic basis for this type oftreatment. While others have explored the subject ofstress mainly from the endocrine point of view, Laborit and his associates were primarily interested in elucidating the part played by thenervous and cardiovascular systems. Inessence, he defends the thesisthat, particularly during acute stress, many vital processes depend largely upon the ionization ofhydrogen , which exerts an important influence upon vasomotor phenomena. Laborit emphasizes the relationships between the "lytic cocktails" used in connection with artificialhibernation and the tranquilizers as used in psychiatry. Indeed, the present volume is merely regarded as the first ofa series presented from the surgeon's point of view. The author promises to describe the specific application of his concepts to other specialties, particularly neuropsychiatry, in a subsequent volume. "To our mind, no progress in psychiatry can be...