68 Book Revriews

68 Bo eiw
be available to such workers mainly as a relatively up to date text available in a
departmental library. It is unlikely to be bought by individuals especially at a price
which at the present rate of exchange is nearly £16. It will not be of much help to
clinicians in understanding this field.
The book is divided into three main sections (1) biochemical analysis of metabolic
pathways, (2) membrane function and neurotransmission and (3) hormonal and
pharmacological studies.
A good general introduction to each of the sections is lacking and there is no attempt
to integrate the presentations in any way. No discussions of papers are given so that
it is impossible to assess the value of a paper unless one already has a detailed know-
ledge of the particular topic in question. The sectional titles suggest comprehensive
coverage but there are some omissions. For example, only one paper by L. Valzelli
discusses the role of catechol and indolylamine neurotransmitters in CNS function.
There are no papers which discuss the role of amino acids as putative transmitters.
On the other hand there are papers of wide interest, such as those by Mcflwain
discussing the role of adenosine in brain intra-axonal transport and young amine
granules by Dahlstrom and Haggendal and an excellent review of microanalytical
methods in neurochemistry by Neuhoff and Di Carlo on the organization of membranes
and organelles in nerve tissue. In addition Gispen and his group present three papers
on the effects of hypophysectomy and fragments of the ACTH molecule on behaviour
and brain protein synthesis. Some of the last named work is rather dated.
Nachmansohn contributes a paper on the importance of structure and organization
for chemical reactions in excitable membranes. These papers are selected for mention
mainly because they interest the reviewer, but other readers may find alternative
papers to hold greater interest.
Two years has elapsed since the symposium and this must be borne in mind in
considering the information in the papers. The book is well printed and produced
but the typescript is rather small although clear. Diagrams are well reproduced.
H. W. READING

THE CREVICULAR FLUID: MONOGRAPHS IN ORAL SCIENCE, VOL. 3.

By G. CnUSONI. S. Karger, Basel, 1974. Pp. vi+122. £8.20.
In 1958 Brill and Krasse described a technique for collecting on a strip of filteT paper,
the fluid produced in the crevice between the gum margin and the tooth, and sub-
sequently in 1962 Brill published a monograph on the properties of this fluid. Since
that time there has been a steady increase in information on the subject: it has been
shown that Brill's collection technique itself stimulates the fluid flow, and in addition
to mechanical stimulation the flow can be increased by histamine. The rate of flow
also correlates positively with several indices of gingival inflammation. A number of
reports have claimed to show zero flow in animals with no gingival inflammation but
human subjects with an undoubted absence of gingivitis are sufficiently infrequent to
leave open the possibility of a low unstimulated flow. However, there is evidence that
the fluid passes through the crevicular epithelium which is considerably thinner than
the exposed oral epithelium.
Since both gingival inflammation and fluid can be detected in most normal subjects,
observations in practice have to be made on the product of an inflammatory reaction,
which leads in turn to a contribution to the components in saliva from this neglected
 Book Reviews 69
source. Most of the albumin and leucocytes in mixed saliva are derived from the
gingival crevice, together with a proportion of many other constituents. There is also
a traffic in the opposite direction - a fact which Cimasoni chooses to ignore. It is well
known that various kinds of mechanical stimulation to the gingival region lead to
transport of bacteria from the crevice to the bloodstream, presumably accompanied
by other components. The dynamics of fluid flow in the crevice during, for example,
chewing, are clearly more complex than current theories allow.
The amounts of fluid which can normally be collected are of the order of tenths of a
milligram. It is scarcely surprising therefore that analyses show wide discrepancies.
Nevertheless clear correlations have been reported between fluid composition and
various direct and indirect measures of tissue breakdown. In particular there are
hopes that the fluid may provide a means of quantifying the severity of gingivitis,
which is notoriously lacking in precision when assessed clinically.
This monograph reviews in detail the evidence available and firmly supports the
inflammatory origin of the fluid. It is a useful reference source for those working in
the field and will provide those interested in related fields with a convenient statement
of progress in a developing subject. The printing and production are in keeping with
the standards set by the price.
C. P. WALLIS