Book Review

Walter and Israel General Pathology

N Engl J Med 1997; 336:666February 27, 1997

Article

Walter and Israel General Pathology
Seventh edition. Edited by J.B. Walter and I.C. Talbot, with five others. 952 pp., illustrated. New York, Churchill Livingstone, 1996. $139. ISBN: 0-443-04296-9

This textbook of pathology was written with the expressed objective of describing the fundamental processes of pathology in relation to the practice of medicine, especially as it pertains to patient care. To provide a full understanding of the subject, the authors have included appropriate discussions of aspects of physiology, anatomy, immunology, biochemistry, hematology, microbiology, molecular biology, and genetics. There are descriptions of basic pathological processes and precise definitions of terminology essential for understanding and communicating the principles of pathology. The authors make no attempt to give a comprehensive account of recent advances.

This edition, the seventh, comes eight years after the previous edition. There are many changes in authorship, format, and content. Dr. J.B. Walter remains editor, but Dr. Martin Israel has passed his task as coeditor to Dr. Ian C. Talbot. Several contributors have been added. Dr. Angus G. Bird has completely rewritten the three chapters on immunology. Dr. Phillip F. Halloran has revised his chapters on tissue transplantation and on the HLA system, and Dr. H. Allen Gardner has updated his chapter on the genetic basis of medicine. Dr. Mark Zuckerman has updated and, in many areas, rewritten his two chapters on viral infections. Finally, Dr. Alastair Forbes has reviewed and updated several chapters relating to endocrine function, calcium metabolism, body fluids and electrolyte balance, and disorders of the heart, lungs, kidneys, and liver.

Numerous topics have been introduced or updated. The sections on molecular biology have been expanded, particularly those relating to the techniques of recombinant DNA and to the topics of in vitro fertilization, genetics, identification of forensic cases, pathogenesis of infection, and neoplasia. The utility of the polymerase chain reaction is stressed. Additional topics that have been introduced or updated include cell receptors; adhesion molecules in relation to cell function, inflammation, and growth; and peptide regulatory factors, particularly the interleukins and growth factors. The section on the pathogenesis of infections has been expanded to include discussion of cell receptors, tumor necrosis factor, and the action of superantigens in meningococcal and streptococcal infections. Several additional diseases have been included in this edition, including bacillary angiomatosis, podoconiosis, plague, tularemia, and listeriosis. The etiologic agents of cat scratch disease and viral hepatitis have been further elucidated. Sections on tumor metastasis have been expanded, and discussions of oncogenesis have been updated to include the role of oncogenes and suppressor genes, especially in familial tumors. The classification of lymphomas has been updated, and the subsets of malignant lymphoid cells and their markers have been aligned with the lymphoid cells involved in the leukemias and in the immune response. Discussion of the role of the endothelium in the circulation has been expanded. Finally, the section on the composition of amyloid and its associated disease states has been updated.

The photomicrographs and electron micrographs in this edition are in optimal focus. The diagrams, illustrations, and tables are clear and useful, but all are in black and white, which can be tiring for the reader. Additional pathogenetic flow charts and diagrams could have reduced the need for some of the text. References at the end of each chapter have been updated to include mostly those that are less than 10 years old. The index is well organized, comprehensive, and useful.

In summary, this edition is a marked improvement over previous editions, with many updates and revisions. The morphologic descriptions are too sparse to be of use to the practicing pathologist, but the book should be most useful to students who need a broad, general treatment of pathology.

Elizabeth Ann Manci, M.D.
University of South Alabama School of Medicine, Mobile, AL 36617