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both their relationship with each other and those with
whom they come into contact. If the longed-for child
finally arrives, the stress does not go away but continues
to impinge on their coping abilities and their reactions to
each other and to the baby. Beth Cooper-Hilbert provides
a comprehensive guidebook through all the emotional
stages of infertility. Her relaxed style makes for easy
reading of the case examples in which couples describe
their feelings and reactions to their predicament.
For the lay reader, the book starts with a brief overview of the medical aspects of infertility. A description
follows this of the normal development of a relationship
and how this can be stalled and traumatized by infertility.
The third chapter is perhaps the most useful for anyone
involved in counselling infertile couples. It describes in
detail the different stages the couple goes through before
they reach emotional healing, followed by a careful account of how a psychotherapeutic intervention can guide
and help them. At each of those stages, psychotherapy
has some helpful questions and tasks for the therapist to
work on with the couple, enabling them to move past the
current crisis and find life meaningful and productive
again.
The book goes on to describe the impact of gender,
religion and culture, and it has a chapter using genograms to explore issues in relationships. The penultimate
chapter deals with those involuntarily childless but not
necessarily infertile: the single, and lesbian and homosexual couples. The book closes with a chapter on moral,
ethical, religious and legal aspects. The secrecy component of donor insemination, egg and embryo donation
and the problems associated with surrogacy are discussed.
The final section is devoted to genetic engineering,
emphasizing the positive aspects and urging all to keep
abreast with research and show vigilance to ensure that
such techniques promote health and well-being.
Although some GPs might find this book somewhat
long it provides easy reading and gives excellent insight
into couples’ feelings as they go through the infertility
nightmare. Chapter three is the highlight of the book and
worth studying in detail, its helpful summaries and lists
providing useful reference material.
PATRICIA PROSSER
GP in Witney
A colour handbook of occupational dermatology. JSC
English (ed.). (192 pages, £29.95. Hardback £48.00.)
Manson Publishing Ltd, 1998. ISBN 1-874545-91-X,
Hardback 1-874545-58-8.
The biggest anxiety for new entrants to the speciality of
Occupational Medicine is with dealing with an occupational dermatological condition. Neither the complexity of
Health and Safety legislation nor the potential difficulties of communicating medical opinions to management
in an ethical manner are as challenging. Without
adequate training, they might be expected to diagnose
the condition and suggest appropriate lines of treatment,
or some effective preventive procedures! The fears are
real, for as is correctly pointed out by the authors, skin
conditions take second place only to musculoskeletal
problems, in the league table of causes of ill health in the
workplace.
This book is likely to help new entrants and old hands
alike. It is slightly larger than A5, softbound, with 186
pages of text interspersed with over 300 colour photographs, the majority of which are well reproduced and
of high information content. Twelve chapters cover a
diverse range of workplace sensitizers and I was pleased
to see that it is not restricted to the traditional chrome
nickel and cutting oil type of examples. The authors
reach far and wide into almost every occupation citing
such examples as garlic dermatitis in a chef, dermatitis of
the hands from dough contact in a pizza baker, contact
dermatitis in beauticians handling false nails made of
acrylic monomer and acne mechanica in a violinist. They
also give detailed descriptions of the various occupational skin pigmentations and give a satisfactory outline
of dermatitis arising from contact with plants and wood.
There is a well-illustrated chapter on occupational
skin cancers. The chapter on the differential diagnosis
of hand eczema is detailed and practical and will be of
use to the GP or practising occupational physician on
an almost daily basis. This is a good book. It is essential
reading for those who wish to be dermatologically wellinformed.
GWILYM HUGHES
Consultant Occupational Physician
ABC of allergies. SR Durham (ed.). (74 pages, £14.95.)
BMJ Publishing Group, 1998. ISBN 0-7279-1236-4.
Allergy is a complex mechanism involving many organ
systems in the human body. Most textbooks describe the
mechanism extensively, followed by a brief description
of the possible manifestations of allergy. This book is
different. Chapters about mechanisms, epidemiology
and diagnosis are followed by chapters about 12 clinical
manifestations of allergy. These include summer hay
fever, perennial rhinitis, allergic eye disease, asthma and
allergy, occupational asthma and the avoidance of exposure to indoor allergens, allergic manifestations on the
skin, allergic reactions to food and drugs, venom allergy
and anaphylaxis.
Each chapter provides a rational basis for specific treatment, but the common denominators in allergy have
not been forgotten. These are discussed in Chapters
three and four. Chapter three is about the backgrounds
of diagnosing allergy and describes characteristics of both
in vivo and in vitro tests. The importance of the patient’s