This book’s stated aim is “to provide guidelines for primary care physicians in the diagnosis and management of a broad array of pulmonary problems”. This is an American book in style and content. Many of its numerous authors passed through the training programme of the Pulmonary and Critical Care Department of the Boston University School of Medicine, and this book in many ways reflects the practice and teaching of this unit and, more widely, the practice of pulmonary medicine in a North American managed care setting.

It follows a structured format with each chapter being divided and subsequently subdivided into numerous sections. The aim of this format is presumably to enable quick reference although, as each chapter does not follow a uniform format (a difficult task given the scope of this book), this is not really achieved. All the usual areas of respiratory medicine are covered including some that will be unfamiliar to many readers such as sick building syndrome. Factual presentation is clear and concise although a greater use of figures would have helped to break up the text, which is in quite small print.

My main criticism of the book is that it is not quite detailed enough to be a reference book for a career chest physician, yet it is probably too detailed for the average primary care physician. Its most likely use would be as a quick reference textbook for pulmonary physicians in training, although it is too big to be carried as a pocket reference.—SPR