Book Review

Crohn's Disease

N Engl J Med 1996; 335:1693-1694November 28, 1996

Article

Crohn's Disease
(Gastroenterology and Hepatology.) Edited by Cosimo Prantera and Burton I. Korelitz. 591 pp., illustrated. New York, Marcel Dekker, 1996. $150. ISBN: 0-8247-9410-9

Gastroenterologists who believe that “to know Crohn's disease is to know medicine” may overstate the case. Yet physicians familiar with this singular chronic illness cannot help but be struck by its variable clinical course and the diversity of its clinical features. Such physicians are bound to welcome this new, multiauthored textbook devoted to Crohn's disease. Drs. Prantera and Korelitz have assembled an impressive list of experts from around the world, many of whom are or have been affiliated with Mount Sinai Hospital in New York, where Crohn, Ginzburg, and Oppenheimer first described “regional ileitis” in 1932. In fact, the book opens with a lively conversation conceived by Henry Janowitz, the current mentor of Mount Sinai gastroenterologists, and conducted “on the other side” with his mentors — Crohn, Ginzburg, and Oppenheimer. The conversation focuses on the specific discoveries of each of these pioneers and how the disease came to be named for Crohn. Greatly softened are the once harsh controversies about who discovered various aspects of the disease.

The book considers every aspect of the disease: epidemiologic data, pathological characteristics, pathophysiologic features, potential causes, clinical and psychosocial features, and complications, as well as diagnostic approaches, management strategies in various clinical settings, and specific treatments. Although broad and detailed enough to serve as an encyclopedic reference, the book also warrants being read for its own sake. The editors have avoided misplaced efforts at forcing uniformity among the chapters, which vary considerably, depending on the author's style and the nature of the subject. This is as it should be and makes for more interesting reading. A rigorous, detailed compilation of the causes and mechanisms of Crohn's disease, with more than 300 citations, cannot fit the same mold as a compelling description of how this devastating illness has altered the lives of physicians afflicted with it. Most of the chapters are followed by brief commentaries by the editors and other contributors, which with varying degrees of success attempt to highlight the strengths and any controversial aspects of the chapter discussions.

A second edition is virtually certain to be published and would be considerably strengthened if the “conversation” with the discoverers of Crohn's disease included citations to their classic papers and if all the commentaries provided truly substantive concepts to enrich the chapters. Despite these minor shortcomings, Crohn's Disease is an excellent, unusually readable book.

Robert M. Donaldson, Jr., M.D.
Yale University School of Medicine, New Haven, CT 06510