FAINTING.

by Dr. George L. En gel '34.Charles C. Thomas, Publisher, 1950. 141PP., $2.75.

The author is Associate Professor of Medicine and Psychiatry in the School of Medicine and Dentistry at the University of Rochester (N.Y.). He has written a valuable book, covering a subject which is poorly understood by most physicians and which has been investigated intensively from the physiological and psychological points of view only in the last twenty years. Dr. Engel is admirably suited to write a monograph on this subject because of his thorough grounding in cardiovascular physiology and in psychiatry.

Various types of fainting are described and explained: first, types due to fall in arterial blood pressure (vasodepressor syncope, orthostatic hypotension, sudden increases in intrathoracic pressure); second, cardiac standstill due to various types of organic heart block and the interesting group of cases due to reflex heart block; third, cerebral vascular disorders; fourth, disturbances in cerebral metabolism; fifth, hysteria; sixth, hyperventilation; seventh, other types of heart disease. There are interesting chapters describing physiological derangements occurring during air travel, as well as mechanisms associated with sudden death. The author has included much of his own important research work in these various fields. Lastly, there are valuable chapters on the diagnosis of syncope, including the important measures to be employed in studying the condition; and on differential diagnosis, indicating methods for distinguishing syncope from epilepsy, vertigo, and more rare conditions. The book is written in a clear and concise manner, has a valuable bibliography, and is an important reference work.