Leo H. Criep ALLERGY AND CLINICAL IMMUNOLOGY New York: Grune & Stratton, 1976, 641 pp., $45.
Dr. Criep has produced a concise, lucid, and easily understandable book on a subject about which he has taught, lectured, and written for a great many years. In the first section of the book, Dr. Criep and his collaborators, Drs. Bruce S. Rabin and Alan Winkelstein, do an excellent job on basic immunology as it relates to conditions seen in private practice. This is particularly true in dealing with the immunology of diseases of the skin. Drs. Winkelstein, R. K. Shadduck, and Z. R. Ziegler wrote the section on immunohematology. Most of the text was written by Dr. Criep.
The pediatrician can obtain much useful information from reading the chapters on gastrointestinal allergy, diagnosis and management of atopic diseases, bronchial asthma, and perennial and seasonal allergic rhinitis. Throughout his book, Dr. Criep has indicated the drugs that are useful in pediatric practice. However, some medications, such as Paredrine sulfathiazole nasal solution (page 214), are no longer available.
Some of the prognostic implications in reference to pediatric allergy concerning "untreated nasal allergies becoming complicated by the appearance of nasal polyps" and failure to institute early treatment - so that "bronchial asthma develops into emphysema, chest deformities and bronchiectasis" (page 207) - may be questioned.
Proofreading and editing were poorly done in many chapters of the book. Typographical errors are evident throughout. Figure 14-5, on page 115, shows several misspelled words in reference to drugs and chemical mediators. A glaring example of poor editing appears on page 421, with a boldface chapter heading on ocular allergy in which ocular is misspelled. In the index, a reference to disodium cromoglycate on page 196 fails to be supported by any mention of the drug on that page.
Although the typographical errors and poor editing may be considered minor infractions, a rather serious error occurs in the section on basic immunology. On page 112, it is stated that practolol is a beta-1 stimulant, when it is really a beta-1 blocker. However, on page 116, the author correctly identifies practolol as a beta-1 adrenergic blocking agent acting on the myocardium but not on beta-2 bronchial receptors. This, he points out, rightfully, is in contrast to propranolol, "which reduces myocardial contractility" but "prevents the bronchodilating effect of catecholamines exposing the patient to the bronchoconstricting effect of the vagus nerve."
In the chapter on bronchial asthma, relative to the treatment of status asthmaticus in children, no mention is made of the use of intravenous isoproterenol in life- threatening situations. The decision to intubate and mechanically ventilate a child can often be avoided by the early use of isoproterenol administered intravenously.
All in all, this book offers the pediatrician an excellent review of the state of the art of newer immunologic concepts. Dr. Criep also provides "pearls" of a practical nature, useful in the diagnosis and treatment of allergic conditions in pediatrics. Although the author is an internist, his grasp of allergy relating to children is impressive.