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21 Medical Mysteries.
  1. J S MORRIS, Consultant Physician
  1. Princess of Wales Hospital
  2. Brigend, UK

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    21 Medical Mysteries. By J Dickinson. (Pp 253; £15.95.) The Book Guild, 2000. ISBN 1-85776-4994.****

    Professor Dickinson has written an intriguing book. As a well known physician and clinical scientist he has witnessed at first hand medical mysteries being discussed and sometimes solved. In this volume he records his personal observations on a number of topics.

    Each chapter is devoted to a particular illness, symptom, or physical sign. The topics are widely chosen and each is stimulating. In a section on asthma, for example, he suggests that television sets may be partly responsible for the increasing incidence of the disease. High voltages generated by television sets attract electrically charged dust particles which could act as lung irritants. Dickinson's chapter on fainting promotes his hypothesis of “collapse firing” of low pressure baroreceptors in the right heart consequent upon diminished venous return. This in turn leads to a centrally mediated dilatation of systemic blood vessels and loss of consciousness. Other chapters in the book ranging from Alzheimer's disease to chronic fatigue, irritable bowel syndrome to inflammatory bowel disease, and migraine to motor neurone disease have equal appeal and contain snippets of valuable information. There is an excellent chapter on finger clubbing and lucid chapters on essential and renal hypertension.

    For whom is the book intended? The author clearly intends in his introduction that the book should be read by non-scientists. I suspect however that the volume will appeal mainly to clinicians as bedside reading. I enjoyed this book and look forward to a second volume on medical mysteries.