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The American Board of Legal Medicine was incorporated in 1951. Its membership is limited to doctors who also possess a degree in law or who have had at least five years' medicolegal experience. Since its founding, this organization has sponsored a number of meetings. This book represents a collection of papers presented at these meetings on a number of medicolegal subjects. The papers themselves may be said to represent the expression of opinions of the men who have taken the time and trouble to present a point of view. Individually, the papers are of uneven quality. Collectively, they are of interest as they reflect the character of the sponsoring organization.

Although hallucinogenic drugs have been used for various purposes for centuries, serious medical studies of them began only about one century ago. In more recent years the use of compounds like D-lysergic acid diethylamide (LSD-25), as well as congeners and derivatives, has become the subject of scientific scrutiny. Of major interest to the practicing physician is the value of these compounds either as therapeutic agents or as adjuncts to psychotherapy. While the evaluation of the psychotherapeutic procedure itself is certainly not readily achieved statistically, the psychopharmacologic action of these drugs can be and has been determined by replicable techniques on man. More than 1,000 papers have appeared on the general aspect of the subject since 1943. Previous conferences have tried to integrate results and to clarify the value of these drugs. The present volume covers an extended conference of the Royal Medico-Psychological Association in 1961. Here are reported the papers

To the Editor:— Dr. Collins' criticism of my definition of placebo is somewhat tangential to the main emphasis of my paper, which was on the etiological factors in the placebo effect and not on the definition. The basis for my definition was discussed extensively in another paper referred to in the article.1 Dr. Collins avoids the problem of proposing a formal definition. Hisimplieddefinition seems to be: "A placebo is what a somebody does to a somebody" which is thought by the latter to be helpful. This definition has several shortcomings: negative placebo effects, which may arise when the patient thinks the doctor isnothelping, cannot be included in his definition. I agree with Dr. Collins that the placebo should refer to therapies and that physician and patient, or their cultural and symbolic representatives, are essential to the definition. But a definition should include more than this

THERE IS A STORY that tells of a wise old lady who had reached her last hours. Her best friend managed to arouse her long enough to ask: "Tell me, what's the answer?" The woman opened her eyes and said, "What is the question?" Defining the question has always been half the answer, and the question before us now concerns a nationwide plan for continuing medical education. The American Medical Association Board of Trustees has approved implementation of the plan, beginning on a pilot scale, using the monograph, "Lifetime Learning for Physicians" as a guide.1,2 The objectives of this paper are at least three-fold: (1) to inform you of this nationwide plan if you do not know about it, (2) to add to your information if you do, (3) and to explore at least two misunderstandings—the first, that an authoritarian agency is being planned, and second, that a scheme

Any physician seriously interested in the pathogenesis of peptic ulcer will find much of interest in this symposium presented at the Second World Congress of Gastroenterology in Munich in 1962. A remarkably catholic selection of 63 teachers and investigators from countries as diverse as Nigeria, India, Japan, and Hungary present 36 papers reviewing current work, concerned largely with the physiological processes attendant upon experimental ulcer production in animals. Dr. S. C. Skoryna has done a fine job of editing out linguistic idiosyncrasies which so often mar these international symposia, but he contributes a mathematical analysis and discussion of "stochastic processes in the causation of peptic ulcer" which can only be classified as ulcerogenic. Gastroenterologists interested in research will want to have this book on their shelves for ready reference, but clinicians will probably prefer to consult a copy in the library. When they do, they will find much useful material.

So many words have been written and so many more have been uttered on this topic that an enormous difficulty is presented to anyone invited to prepare a paper. Evaluation has been defined, described, decried, and defended. The lack of evaluation has been bemoaned, bewailed, and bemused. The need for evaluation has been expressed, exhorted, and extolled. Approaches to evaluation have been proposed, proclaimed, and provided. All in all, one wonders how so much effort can have brought about so little effect. Perhaps that last statement is too harsh; in our interest in the well-turned phrase, we often tend to exaggerate. Indeed, there is every indication that the need for evaluation is now widely accepted. There is no question that evaluative approaches and techniques have become more sophisticated over recent years. There is no question that there is a greater understanding of evaluation as a concept and a process. There

To the Editor.— The reply to your fourth EDITORIAL, "Community Medicine: A Concept in Search of a Definition" (224:522, 1973) is eloquently stated in the three editorials that preceded it. The three editorials based upon papers withinThe Journaldiscuss the relationship between occupation and disease pattern, the importance of research on adverse drug reactions enabling physicians to assess the cost-benefit ratios of prescribed medicines, and an increased incidence of coronary disease among urbanized bedouin. The editorials all pose problems, but give no final answers. They indicate the changing face of disease as it appears to the practicing clinician and demonstrate the complexity of problems facing the doctor in the community. Yet, Dr. Ricketts, in the following editorial on community medicine, remarks that there is no need for such "a splinter department" and that the subject matter of community medicine does not warrant "the dignity of an academic title." The

From time to time I am asked this question by the head of a department in a medical school or other health organization. When the advice requested is more than the naming of a possible candidate, I remember an attempt that I made seven years ago to organize my thinking about the situation of persons who are expected to give help in a miscellany of problems brought to them from any or all departments in a medical school. Such statisticians might be called "all-purpose statisticians" or "statisticians at large," even if they are based in a particular department such as preventive medicine or pharmacology. I presented the results of my thinking at the Fourth International Biometric Conference held in Ottawa, in 1958, in a paper entitled "Some Non-statistical Problems Met By Medical School Statisticians." I read it again recently and asked myself: "Have some or all of these problems disappeared

To the Editor.— Bellville et al ( 217 :1835, 1971) present an interesting and provocative analysis of the influence of age on pain relief from analgesics. However, in their discussion they refer to an old paper by me and my former colleagues at Harvard that interprets peculiarly both our data and theirs. They interpret our findings of a relationship between placebo response and age as reflecting "a difference in sensitivity to pain and its interpretation." I have never been sure how to analyze our correlation, but believe that the facts are reasonably clear, ie, older people tend to respond to placebos with a greater frequency of beneficial response than do younger people. This was the case not only in relieving pain but also in a separate placebo study that involved the administration of inert medication designed to influence reports of energy and appetite. If our findings are correct, they have important

Scientific and empirical information exchanged at last month's Symposium on the Use of Anticoagulants, held in Miami Beach, dealt principally with these two questions: Should anticoagulant drugs be used in treating ischemic heart disease? How should a controlled study be administered to assure the highest degree of scientific validity? Two investigators—Arthur J. Seaman, MD of Portland, Ore, and Christian F. Borchgrevink, MD of Oslo, Norway—express their differing views on these questions in the following MEDICAL NEWS debate. Their respective papers are also reported in this issue.

This little book has a remarkable history. A paper by Drs. Richard K. Young and Benjamin S. Patrick, "Outpatient Pastoral Counseling in a Medical Center," was published in The Journal on Septemberber 6, 1958. Mr. Clarence Hall, senior editor of the Reader's Digest, was so impressed with it that he made two visits to the North Carolina Baptist Hospital, the teaching hospital of the Bowman Gray School of Medicine, to collect material for an article on the work of Chaplain Dick Young and his associates in the department of pastoral care. In order to justify the length of the article, he published it in the Book Section of the Reader's Digest as "condensed form of a forthcoming book" and extracted a promise from Dr. Young that he would write the book thus condensed. "Spiritual Therapy" is the result.The book shows a new approach to the relation between physician and

This book consists of collected papers which outline laboratory procedures for estimating the various lipids and steroid hormones. There is little continuity of the collected data from one chapter to the next. The clinical interpretation and application are meager. The book, therefore, should be more useful to the biochemist or physician interested in basic analytical research than to the practicing or clinical investigative physician.

This new textbook printed on good quality paper with good type is pleasantly readable. The author has made some new approaches to facilitate the teaching of gynecology. The purpose of the book is to present a new and modern summary of present-day gynecology in a brief and clear manner. Most textbooks are much too detailed and contain so much philosophy that they are too voluminous for practical purposes. This book may act as an outline for teachers, and, in addition, it is intended to interest the practicing physician. Pathology is stressed. After the pathogenesis of the individual disease has been considered, the symptoms of the patient become more understandable. Similarly, the diagnosis based on the physical examination and laboratory findings may be reached more logically, and the treatment can be more appropriately prescribed. Certain operative techniques are described briefly. The author spends much time describing the various hormones and their

This book continues the fine tradition of summarizing the important publications of the past year that relate to pathology. The editorial comments of the author, as usual, help place the contributions of these papers into proper perspective. After reading this book, one has the feeling that few new techniques are described, and few new areas of interest have been opened up during the past year. The single special article by Dr. Robert Schrek, entitled Fashions in Cancer Research, is an interesting analysis of the trends in cancer research over the years. He explores the controversy over the role of experimental tumors, the furor over genetic or environmental factors in experimental cancers, and the current interest in viral etiology of neoplasia. The possible effects of these fashions in research on the outcome of the quest for solution to the "cancer problems" are considered.