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This book, a revised edition of Man at High Altitude and written by the same authors as the first two editions, was retitled because they placed "increased emphasis on the clinical aspects of man’s adjustment to hypoxia and cold" in this edition. They have also incorporated much of the new information from studies of mountain climbers and natives in the Himalayas. The reviewer notes also that this edition reflects a much better coverage of the studies published in the U.S. literature outside of standard physiological and medicine journals. Despite the very specialized nature of the new title, this book with its profuse illustrations and broad array of topical headings was apparently designed to appeal to the interested layman as well as to research scientists and physicians. Such readership is in many ways desirable, in view of the large number of amateur mountain climbers and other tourists who now sojourn in the high altitude area of the world. Nevertheless the reviewer hopes that the reader will not take all of the sections too literally. Speculation that Sherpa mysticism is caused by the high mountains they live in and that the Yeti of Nepal was transformed into the Sasquatch by Indian migrants to North America is best discussed only after several drinks. In thirty three chapters the authors attempt to cover almost all aspects of how the reduced atmospheric pressure and low temperatures found at high terrestrial elevations affect the natives, migrants, and sojourners to these regions. Such a task is patently impossible in a single volume, considering that people are not only directly affected by atmospheric pressure and cold but also indirectly through the biota including infectious diseases which respond to the same climatic factors. The strength of the book is in its many chapters which comprehensively describe the morphological, physiological, and pathological characteristics found among natives and sojourners at high altitude. The authors also provide the best explanations available of the mechanisms whereby hypoxia contributes to these characteristics. As the new title reflects, the chapters on the nature, causes, and treatment of clinically important conditions are particularly comprehensive. The reviewer has only two reservations about these sections of the book. Firstly the authors should have provided a clearer delineation of the similarities and differences between the effects of short and long term exposure to high altitude. They should also have more specifically differentiated pathologies common to natives and upward migrants. Secondly when the authors try to prove that the Tibetans may have had a longer time than the South American Indians in which to adapt genetically to high altitude, they appear to have neglected to consider the Pleistocene climate change. Indeed it seems very unlikely that anyone was able to live in these regions prior to ten to fifteen thousand years ago. It is of course always a reviewer’s duty to criticize where reasonable but it must be recognized that this is the most authoritative and comprehensive coverage of high altitude effects which has been written. The contents of the book form a solid base for future research and clinical medical practice related to people at high altitude. It should probably also be studied by anyone planning ventures into the high mountains be they trekkers or astronomers working atop Mauna Kea in Hawaii. PAUL T. BAKER | ||||||