Physiologic Basis of Respiratory Disease
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《新英格兰医药杂志》
Textbooks on pulmonary physiology are represented at one extreme by introductory monographs and on the other by the American Physiological Society's inaccurately titled Handbook of Physiology, with its dense volumes on the respiratory system that are 20 years old and 20 pounds heavy. Physiologic Basis of Respiratory Disease aims for the middle ground — it is neither simplistic nor comprehensive. Nevertheless, it has some idiosyncrasies that may limit its usefulness.
The book is a tribute to the Meakins–Christie Laboratories at McGill University, which for decades has been a powerhouse of research on pulmonary physiology. Most of the authors have some current or past association with the laboratories, and they constitute a remarkable pantheon. However, this focus on one institution disproportionately emphasizes the research that has been conducted there. About a quarter of the chapters address the physiology of respiratory or skeletal muscles. Another quarter is focused on airflow obstruction. Other topics one might anticipate in such a textbook — for example, dyspnea, heart–lung interactions, the effects of altitude or microgravity, or the transition from fetus to infant — are mentioned only in passing or not at all. These omissions give the book the flavor of a compilation, rather than a systematic textbook.
The editors have defined physiology inclusively, and a strength of the book is its crossing of the typical boundaries among subdisciplines, covering classic mechanics to genomics. Mathematics and physics are used sparingly, a feature that keeps the book accessible to those of us with a liberal-arts education. In this multiauthored book, the chapters vary from the sublime to the soporific. Several chapters are high points. A chapter on ventilation–perfusion matching and the technique of analyzing gas exchange with the use of a mixture of inert gases renders those opaque topics nearly comprehensible. Peter Macklem republishes a thought-provoking, philosophical essay in which he defines life itself as the proper mix of enthalpy and chaos. A chapter on the genetics of pulmonary diseases is an excellent primer on the topic. The coverage of muscle function, although perhaps hypertrophic, is masterly and timely. Similarly, the many chapters on airway disease sum up to a very thorough presentation, from the spirogram to the genome. Any insecurities that physiologists may harbor about their relevance in this age of genetic medicine should be relieved by these chapters.
Because of its omissions and emphases, this book would not suffice as the sole textbook of pulmonary physiology on a bookshelf, nor could it serve as a course textbook. It could not replace clinical textbooks of pulmonary medicine either, because its coverage of disease is spotty. A medical student would find it overwhelming, and a medical resident or respiratory therapist would find it impractical. However, a pulmonary fellow, pulmonologist, or anesthesiologist with a special interest in physiology would find this book useful. Its best audience may be physiologists and teachers of pulmonary physiology. Educators could improve their own teaching of complex concepts by adopting the clarity of many of the authors. Those familiar with the field could put the viewpoints of the Meakins–Christie researchers into context. The accompanying CD-ROM also facilitates inserting electronic versions of figures from the book into slides. Sophisticated students of physiology, and their teachers, will enjoy this work as a topical review and reference book.
Henry Fessler, M.D.
Johns Hopkins University
Baltimore, MD 21287
hfessler@jhmi.edu(Edited by Qutayba Hamid, )
The book is a tribute to the Meakins–Christie Laboratories at McGill University, which for decades has been a powerhouse of research on pulmonary physiology. Most of the authors have some current or past association with the laboratories, and they constitute a remarkable pantheon. However, this focus on one institution disproportionately emphasizes the research that has been conducted there. About a quarter of the chapters address the physiology of respiratory or skeletal muscles. Another quarter is focused on airflow obstruction. Other topics one might anticipate in such a textbook — for example, dyspnea, heart–lung interactions, the effects of altitude or microgravity, or the transition from fetus to infant — are mentioned only in passing or not at all. These omissions give the book the flavor of a compilation, rather than a systematic textbook.
The editors have defined physiology inclusively, and a strength of the book is its crossing of the typical boundaries among subdisciplines, covering classic mechanics to genomics. Mathematics and physics are used sparingly, a feature that keeps the book accessible to those of us with a liberal-arts education. In this multiauthored book, the chapters vary from the sublime to the soporific. Several chapters are high points. A chapter on ventilation–perfusion matching and the technique of analyzing gas exchange with the use of a mixture of inert gases renders those opaque topics nearly comprehensible. Peter Macklem republishes a thought-provoking, philosophical essay in which he defines life itself as the proper mix of enthalpy and chaos. A chapter on the genetics of pulmonary diseases is an excellent primer on the topic. The coverage of muscle function, although perhaps hypertrophic, is masterly and timely. Similarly, the many chapters on airway disease sum up to a very thorough presentation, from the spirogram to the genome. Any insecurities that physiologists may harbor about their relevance in this age of genetic medicine should be relieved by these chapters.
Because of its omissions and emphases, this book would not suffice as the sole textbook of pulmonary physiology on a bookshelf, nor could it serve as a course textbook. It could not replace clinical textbooks of pulmonary medicine either, because its coverage of disease is spotty. A medical student would find it overwhelming, and a medical resident or respiratory therapist would find it impractical. However, a pulmonary fellow, pulmonologist, or anesthesiologist with a special interest in physiology would find this book useful. Its best audience may be physiologists and teachers of pulmonary physiology. Educators could improve their own teaching of complex concepts by adopting the clarity of many of the authors. Those familiar with the field could put the viewpoints of the Meakins–Christie researchers into context. The accompanying CD-ROM also facilitates inserting electronic versions of figures from the book into slides. Sophisticated students of physiology, and their teachers, will enjoy this work as a topical review and reference book.
Henry Fessler, M.D.
Johns Hopkins University
Baltimore, MD 21287
hfessler@jhmi.edu(Edited by Qutayba Hamid, )