Family Practice Vol. 20, No. 4, 499
© Oxford University Press 2003
Book Review |
Oxford textbook of medicine. Fourth edition.
David A Warrell, Timothy M Cox, John D Firth, Edward J Benz Jr (eds). (4146 pages, £275.) Oxford University Press, 2003. ISBN 0-19-262922-0.
Professor of Primary Care, University College London
The latest edition of the OTM comes in three heavyweight volumes with tasteful colour scheme and classy smell. Over the past 3 weeks, it has had pride of place on my office table, usually with one or other volume open at a key page. "Cor", is the typical response of colleagues entering the room, "Got a new textbook I see". At £275 and with metallic sheen on the cover as standard, this is the intellectual equivalent of a Jaguar coupé and inspires similar levels of envy. Here is a sample of the questions we road tested it with:
"Can I get Hong Kong flu from going to Hong Kong?" asked an elderly professor. The index lists influenza but not the Hong Kong variety. The relevant section provides a stunningly succinct overview of the subtypes (remember antigenic drift and shift?). The answer to our question lies in a single sentence on 1-325: "The H5N1 virus that recently emerged in Hong Kong clearly had the potential to cause a disease of unusual severity". Bad news for the professor, but smooth transmission by the OTM.
"Is digoxin still the drug of choice for symptomatic treatment of idiopathic atrial fibrillation discovered incidentally in a 55-year-old with no other cardiovascular risk factors and feeling slightly dizzy?" The index lists ‘atrial fibrillation, treatment’, but the corresponding page tells me when and how to anticoagulate. Try the index again, this time following signs for ‘atrial fibrillation, management’, and on 2-988 we find the five words we are looking for: "The mainstay of treatment is [still] digoxin." Rough cornering, but we reached our destination.
"In a 53-year-old man with past history of ulcer, a recent clear endoscopy and a classic story of gastro-oesophageal reflux at night, who can’t be doing with regular prophylaxis, are antacids kept by the bed a reasonable management option?" The OTM index lists reflexology (good grief!) but not reflux. ‘Gastro-oesophageal reflux, management’ takes me to a clear section on principles (provide symptomatic relief, control oesophagitis, pursue sinister features) and a dazzling, bright pink treatment algorithm that leads to a dead end: proton pump inhibitor. What if the patient can’t be doing with them? On reflection, I guess it was unrealistic to expect a menu of options with which the non-compliant individual and his GP could share decision making. I prescribed mist mag trisil. Conventional textbook—don’t drive it off road.
Having completed my review, I am now contemplating where to place this fine collection: in the surgery (to impress the patients), in the living room at home (to inspire the kids) or in my office at the university (to remind me that I was once familiar with a fair proportion of the thousands of diseases indexed therein).
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