High Altitude Medicine and Pathology. Donald Heath and David Reid Williams. Butterworths, 1989. London, 352 pages. $95.00.

The authors are senior pathologists, well traveled in the mountains of Asia and South America, and authorities in the pathology due to altitude. It is strictly a scientific text, an excellent companion to the clinical book by Ward, Milledge and West. Only minor revisions have been made since the second edition (1981), though it falls short in describing many major advances in altitude research made during the last decade.

The authors contend that symptoms experienced by lowlanders going to altitude are “normal.” Less persuasive is their case for defining altitude sickness as either “benign” or “malignant.” Differences between immediate reactions and the slower changes of acclimatization, and adaptation over generations are blurred. Acclimatization is discussed throughout the book rather than summarized in one place. Short chapters on high-altitude telescopes, the Abominable Snowman, exercise at altitude and sleep aren’t appropriate in a pathology text and these are weak. Some of the data are outdated.

There are many references—though too few from recent literature—and the index is excellent. This is the definitive textbook of pathology, but of interest mainly to scientists interested in altitude.

Charles S. Houston, M.D.