Clear view of allergy

Allergies and their management. Ronald S Walls. Sydney: Maclennan and Petty 1997 (ix+259 pp.). ISBN: 0-86433-115-0.

The rapidly expanding field of clinical allergy needs a short textbook on the basics of clinical practice. This book, written by a well-known expert in the field with extensive clinical and research experience, may be of interest to general practitioners and medical students. Its clear introduction outlines the field of allergic disease and the province of the clinical allergist. The critical importance of careful clinical history-taking in the diagnosis of allergic disease is clearly explained, as is the use of diagnostic testing -- giving the reader perspective in a field dogged by alternative practitioners and ill-founded diagnostic tests. The author's experience in clinical allergy practice is also evident in the approach to management of allergic disease, with a succinct Table summarising treatment options. The benefits and potential adverse reactions of immunotherapy are realistically dealt with, as are likely future innovations. There are three distinct sections: Part A is introductory, with an overview of subject breadth, including some chapters on pharmacotherapy in clinical allergy practice; Part B describes clinical entities commonly seen by the practising allergist and serves as an easy reference; and Part C deals with basic immunology and the epidemiology of allergic disease. There is some overlap between the initial introductory chapters on pharmacotherapy and the chapters in Part B, and the chapter sequence differs from the conventional, with basic immunology following the clinical perspective. While the chapter on drug allergies is lucid and well constructed, the rhinitis chapter seems brief for an entity that is a major component of clinical allergy practice. In dealing with asthma, the author does not emphasise the current focus on the objective measurement of lung function or the management plans generated by the National Asthma Campaign. Overall, I believe this book would be useful for general practitioners in their management of allergic disease. Jo A Douglass Physician, Department of Allergy and Clinical Immunology Alfred Hospital; and Monash University, Melbourne, VIC