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By S. A. Morse, R. C. Ballard, K. K. Holmes, A. A. Moreland. Philadelphia: Elsevier, Mosby, 2002. ISBN 0723432279.
What is an atlas? My dictionary was of little help, referring only to the word in its geographical and mythical contexts. Medical atlases that come to mind are largely pictures of the common and the obscure, of varying quality, and accompanied by the minimum of text. Such books are useful when it comes to reassuring young men that pearly penile papules are common and of no clinical significance, and for showing students conditions which they are unlikely to see in real life; but otherwise they tend to sit on the bookshelf after a rash purchase at a medical conference.
The new addition of Morse, Ballard, Holmes and Moreland’s atlas is hardly in this category. Perhaps it might be better described as an illustrated textbook because the text is not an insignificant part of the whole. How then does it stand up in this context? To answer this question I compared it with the genitourinary physician’s bible, the 1999 edition of Sexually Transmitted Diseases. Initially, the reader is struck by the clear layout and larger font size, certainly an advantage for the ageing clinician. The use of colour in charts and diagrams adds to the clarity and the clinical photographs are generally of good quality, although a few require the eye of faith for interpretation.
If the authors are aiming at the test book market, however, the success of the atlas will depend on more than its visual appeal. Clearly there are many aspects of our speciality that do not easily lend themselves to a pictorial format; history, political context, service provision, behavioural data come to mind. These are missing. But a direct comparison of the treatment of a common condition, such as vaginal discharge, between the two books points up considerable differences. Whereas Sexually Transmitted Diseases tackles in admirable detail the microbiology, epidemiology, diagnosis, management, and complications of the various infections, I looked in vain in the atlas to find out whether sexual partners of women with bacterial vaginosis should be treated. There are however novel aspects of the atlas that should be applauded. I especially liked the opening chapter on genital and dermatological examination that brings together the normal and the abnormal in a particularly useful way, especially for physicians with a limited knowledge of dermatology.
Clearly, the general attractiveness of this atlas will ensure its place on the bookshelves of most specialist departments. As an introduction to the specialty, it fills an important niche and might be an ideal purchase for trainees. It cannot however replace Sexually Transmitted Diseases as a resource for serious investigators and may eventually become redundant with the advance of electronic media. In the meantime, clinicians with an idle moment might flick though the pictures reminding themselves of rarely seen conditions. My daughter, glancing over my shoulder, shuddered and insisted that the book should not end up on the coffee table. Perhaps a tribute to the quality of the photographs!
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