BOOK REVIEW
Miller Thomas A. (editor). Modern Surgical Care—Physiologic Foundations and Clinical Applications. Quality
Medical Publishing, St Louis (Missouri) USA. Second edition 1998. 1454 pages. DM 295. ISBN 3-57626-060-7.
This is a rewritten and updated second edition of a
textbook first published in 1988. The purpose of the
second edition (as was the first) is “to bridge the gap
that exists between the font of information about
physiology learned in medical school during the basic
science courses and the commonly encountered in-
ability to apply this information to clinical care”. It is
therefore a book which approaches disease as a
derangement of physiology that is, pathophysiology.
The book encompasses 68 areas within surgery, from
a general chapter on the metabolic response to
starvation and stress to organ specific areas such as
surgery for morbid obesity. There is a massive
dominance of American contributors. Most chapters
start with basic physiology, and pathophysiological
aspects are added. The interested reader may be stuck
with studying areas such as the citric acid cycle,
prophylaxis of endocarditis or vitamin-D metabolism,
just as happens when you search for a word in an
encyclopaedia.
The general format of the book and each of its
chapters starts extremely basic. The reader is then
brought all the way to applications in contemporary
medicine including recommended surgical procedures
for various problems. Quite rare procedures such as
continent urinary diversion are also illustrated. The text
is well up to date with several references up to 1997.
Chapters such as Immunity and The Physiological
1999 Scandinavian University Press. ISSN 1102–4151
Basis for Transplantation exemplify the well written
and well illustrated text. The “down to basics”
ambition is in full bloom in the chapter on Acute
Abdominal Pain which starts with 8 pages of embry-
ology to explain the physiology of the acute abdomen.
Understanding physiology and pathophysiology is to
me what makes the difference between a surgeon and
someone who does operations. This book gives you
answers to most of the problems of physiology and
pathophysiology that might arise in clinical practice
and also gives you suggestions about where to find
more information. It is a useful book that should be
available in all surgical units, particularly where any
teaching takes place. For those of us who have on our
shelves old textbooks in physiology from our distant
years in medical school, this book gives us a chance to
get the surgical physiology updated and put into its
modern clinical context. The 785 illustrations are well
selected and together with tables and condensed lists of
facts make it easy to find the information you need
quickly. The text is so well-written that even non-
broken pages of text are inviting and despite the present
day focus on images as carriers of information, reading
these is surely rewarding.
Svante Nordgren, M.D.
Gothenburg, Sweden
Eur J Surg 165