High Blood Pressure

References

Cite

Share

Abstract

Of the large number of new medical textbooks published in the last few years, very few can be called, masterpieces and almost none is likely to be read, in years to come, as a classic. Professor Pickering's book is certainly the one and may very well eventually take its place as the other. It upholds the best traditions (it is obviously by no mere chance that Sir Thomas Lewis's name appears in the very first line) and it is in every way worthy of the position to which he has recently been appointed. The scope is encyclopaedic, the style lucid and unpretentious, and the approach characteristically English-empirical, reasonable and tempered with humour and understanding. In the introduction (in which the tenor of the whole book at once becomes clear) Professor Pickering's outstanding contribution to the study of this problem is stated with disarming clarity: 'It seems that essential hypertension represents little, and 'perhaps nothing, more than the upper end of the distribution curve ' of continuous variation of arterial pressure in the population at large. As one reads through the chapters describing the factors controlling blood pressure, and the problems of experimental hypertension, to arrive at the author's account of the investigations leading to this conclusion, one feels a sense of relief, as though one had fought one's way through a forest back into the open air and could once again see the wood and not only the trees. Further chapters deal with the clinical features and the treatment of essential hypertension and of the renal and other conditions in which the blood pressure is raised. A final, helpful chapter summarizes practical points in diagnosis and management. There is an immense bibliography. One hesitates to make any criticism of such a book, even if occasion were to be found for it once or twice. The well-recognized syndromes of the cerebral arteries (particularly, for instance, that of the Basilar artery) might be specifically described in the section on transient cerebral attacks. The occurrence of acute nephritis without albuminuria might be mentioned to reinforce the argument on p. 352 (incidentally, it is pleasing to see Longcope given credit for his classification of nephritis). The author seems to be a little pessimistic about the treatment of hypertension with methonium compounds, and a little optimistic regarding hydralazine (mis-spelt hydrallazine). The whole book is a remarkable achievement, written, we are told, in a single term of residence at Magdalen. Academic seclusion has never been better justified! How fortunate is Oxford that this alert and critical mind is to be active there for many terms to come!