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Management of Wilderness and Environmental Emergencies

Management of Wilderness and Environmental Emergencies. Paul S. Auerbach and Edward C. Geehr, editors. Macmillan Publishing Company, New York, 1983. 656 pages, illustrated. $68.00.

Weighing in at over four pounds, and written in medispeak, this is not the book you will choose for your traverse of the John Muir Trail or an attempt on Rum Doodle. Darvill’s small booklet, Mountaineering Medicine, or Wilkerson’s Medicine for Mountaineering is more suitable for that. Nor is it fireside reading for the nonprofessional. But for the emergency-room doctor, and the general physician in communities adjoining wilderness areas, it will be indispensable.

Everything a doctor might need to know and much more is covered in this encyclopedic work: profusely illustrated, adequately indexed and well arranged. The double-column format makes for quick scanning and the chapter headings are excellent signposts. You will learn that beautiful cone shells can kill, that only fifty species of spider found in this country have fangs that can penetrate human skin and are, therefore, somewhat dangerous and that shallow-water scuba diving can be more dangerous than deep dives. More than eighty percent of all animals are arthropods and half of these are insects. A hundred Americans die of plant poisoning each year and the best treatment for hypothermia is still being argued. Just about everything is covered authoritatively. The clinical picture of many problems is not as well done as a harried ER doctor might like to help in his differential diagnosis and the exotic sometimes overwhelms the ordinary. But these are small complaints. The book is a splendid and essential addition to the reference library of all nonspecialist doctors—and to some specialists too.

Charles S. Houston, M.D.