Book reviews

by the sort of painstaking studies
described in this book. This is a 'must'
for all those involved in or commencing
GABA research.

C. D. MAESDEN

The Practice of Pediatric Neurology By
K. Swaiman and F. Wright. (Pp. 1198;
illustrated; £65.70.) Henry Kimpton Pub-
lishers: London. 1976.
Dr Ford's textbook ofpaediatric neurology
enjoyed an exalted reputation well beyond
the sphere of interest of paediatricians and
paediatric neurologists; indeed there were
some who averred that in its time 'Ford'
was among the best of all neurological
texts. The last revision in 1966 was a
valuable but unsuccessful attempt at up-
dating; since then there have been impor-
tant and extensive advances in paediatric
neurology which have sharpened the need
for a replacement, and none of the recent
texts directed to paediatricians and those
with a general interest in paediatric
neurology has sufficed as a work of
reference.

Professor Kenneth Swaiman and Dr
Francis Wright, as co-editors of a two-
volume treatise, have drawn together con-
tributions from 44 other American authors,
and are the first to try and fill the vacuum
left by Ford. But at £65.70 is it worth it?
There are three main sections: 'Evalua-

tion of the patient's problems', 'Symptoms
and signs of neurologic disease in child-
hood', and 'Discussion of neurologic
diseases in childhood', and thus there is a
commendable emphasis on the clinical
basis of paediatric neurological practice.
Many of the authors are accepted experts
on the subjects about which they write, and
their contributions have an authority
which others, written by others with less
experience, lack.
The transatlantic emphasis does not

limit coverage of the world literature but
there are some surprising gaps. For
example, there are only three pages devoted
to speech and language, matters which
have deservedly attracted great attention in
both America and Europe, whilst the
sections on neuropsychiatry, which
occupies a proportionately large part of a
paediatric neurologist's time, seem to lack
insight as well as incisiveness. There are
tautological difficulties over the relation
between migraine and epilepsy (p. 156),
while the section on vertigo owes more to
adult neurology than to an understanding

of the problem in young children. Leber's
amaurosis, a much more frequent cause of
poor vision in childhood than Leber's
disease, is not mentioned, and once again
the genetics of the latter disease is inac-
curately presented. Evidently the author
of the section on movement disorders has
not realised that the patients described by
Pampiglione and Maia suffered from the
same disorder as those presented by
Kinsbourne as the dancing eye syndrome.
As in many neurological texts, thera-

peutics get minimal attention, or is this the
malign influence ofFDA? Casual examina-
tion of the bibliography reveals sufficient
inaccuracies to make one wonder if there
has been systematic checking. Illustrations
are clear and plentiful but not always
relevant.
Although this text will serve as an

important and valuable reference work, it
lacks the authority of Ford. Its place is in
departmental libraries-weight as well as
price are threats to private bookshelves.

JOHN WILSON

The Diagnosis and Treatment of Alcoholism
By G. G. Forrest. (Pp. 257; no price quot-
ed.) Charles C. Thomas: Springfield,
Illinois. 1975.
The author of this book is a clinical
psychologist who is supervisor of an
alcoholism rehabilitation programme at
Army Headquarters, Fort Carson, Colo-
rado. He has a major interest in a psycho-
therapeutic approach to the alcoholic and
problem drinker. His concepts are eclectic
in nature, embracing a much wider range
of therapeutic strategies than might be
expected in certain transatlantic psycho-
analytic strongholds.

Misleading stereotypes of the alcoholic,
leading to therapeutic nihilism, are initially
discussed. Psychotherapeutic tactics are
later described. Principles of individual
psychotherapy on modified Rogerian lines
are lucidly presented. Group psycho-
therapy, however, is rightly depicted as
being currently the most promising treat-
ment modality. Warmth of personality
and a positive liking for problem drinker
patients-not always easy to achieve-are
regarded as important ingredients in the
therapist himself. A success rate of 75 % is
claimed for group therapy over a six month
period-a figure which would seem opti-
mistic in the north of Britain where heavy
drinking receives strong cultural approval.
The book ends with a useful discussion of
the follow-up and evaluation of alcohol
rehabilitation.

This volume is a valuable addition to the
already large literature on alcoholism and
will be informative to all who are involved
in alcohol rehabilitation programmes.

A. BALFOUR SCLARE

Pathophysiologic, Diagnostic and Thera-
peutic Aspects of Headache By M. E.
Granger and G. Poch. (Pp. 128; illustrated;
SwFr./DM 62-, $24.00.) S. Karger: Basle.
1976.
This is the fourth of the series Research and
Clinical Studies in Headache edited by Dr
Arnold Friedman and Dr Mary Granger,
the first of which appeared in 1967. This
volume does not pretend to be compre-
hensive, but picks out selected topics for
its contents. The selection is curious and
the topics seem to contain no thread of
continuity to link the subjects which are
covered.
The first chapter on the head in the body

image concept is typical of the trendy
impressionism perpetrated by the modern
day psychologist cumn sociologist. There is
little attempt to relate the somewhat
speculative conjectures to the patient with
headaches, and one's interest wanes a little
on encountering'. . . found a tendency for
men with high head awareness to be
relatively unconcerned about anal aspects
of behavior, such as obsessive concern
about cleanliness . . .'.
A useful survey of headaches associated

with diseases of the eye by Myles Behrens
covers the major areas of overlap between
the ophthalmologist and the neurologist.
Spira, Mylecharane, and Lance provide a
fascinating account of their experimental
pharmacology of humoral and anti-
migraine drugs on the circulation of the
monkey; to some extent this fills the gap
of the lack of an experimental model for
migraine, but not completely-as the
authors themselves concede. This chapter
complements the following one by Dalessio
which reviews vasoactive substances, vas-
cular permeability, and their role in
migraine. Catecholamines, histamine, sero-
tonin, kinins, prostaglandins, and 'slow
reactive substance (SRS-A)' are considered
as vasoactive substances associated with
inflammation. Some would doubt the
concept of a sterile inflammatory reaction,
postulated by Dalessio, in the absence of
evidence of a cellular response in the vessel
wall in migraine.

Succeeding chapters review the role of
allergy, the place for investigation by

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