128 AMERICAN JOURNAL OF OPHTHALMOLOGY JULY, 1982

ophthalmia, its treatment, and preven­tion.

The first section of the book coversvitamin A deficiency, the biochemistry ofvitamin A, and a description of the Indo­nesian project, including a longitudinalfield study, a hospital-based study, and acountrywide survey. There are detailedchapters on diagnosis, classification, his­topathology, and pathogenesis. The nu­tritional status, contributory and precipi­tating diseases, the epidemiology of thecondition and resulting blindness, andfinally treatment and prevention are dis­cussed.

This volume will be welcomed by thosewho are actively working in this fieldbecause of the very detailed statisticspresented and because of the extensivelist of references. The detailed nature ofthe text makes it rather difficult to re­member the most important conclusionsfrom each chapter and I would, there­fore, have liked a brief summary at theend of each chapter or a final chapteremphasizing what can be done to elimi­nate nutritional blindness.

E. S. PERKIKS

Spontan- und Provokations- Nystagmus,2nd ed. By B. Minnigerode and H. H.Stenger. Berlin, Springer-Verlag, 1982.Hardcover, 1i2 pages, author citationindex, subject index, 102 black andwhite figures. Approximately $41

This is a second edition, in German, ofa book by H. Frenzel originally publishedin 1955. The new authors, both otolaryn­gologists, attempt to impose order on themany forms of vestibular nystagmus(which they curiously call a "symptom"rather than a "sign"). They rely uponvisual inspection of the nystagmus, usingilluminating and magnifying spectacles,and then record their findings on elabo­rate diagrams that indicate the direction,

amplitude, frequency, and other charac­teristics of the nystagmus while the eyesand head are in various positions. A dia­gram describing the nystagmus of a singlepatient may employ dozens of symbolsand occupy an entire page. The authorshave obviously had extensive experiencein the evaluation of patients with nystag­mus and their descriptions are very de­tailed and comprehensive. They tend toclassify nystagmus by the causative dis­ease as well as by the characteristics ofthe nystagmus, so we have nystagmus ofthe Meniere type ("Morbus Menieri suigeneris") and nystagmus caused by fore­brain abscess and disseminated encepha­litis. The resulting classification is pon­derous and differs from one based uponcontemporary theories of ocular motorcontrol and precise clinical localization.

There is little or no discussion of mod­ern concepts of the anatomy and physiol­ogy of the vestibulo-ocular reflex and itsneural integrators. Most American inves­tigators of the vestibule-ocular systemnow rely upon accurate and quantitativeeye movement recordings using the infra­red or scleral coil techniques and direct­current oculography. Visual inspectionmay not be adequate, for example, todistinguish jerk from pendular nystag­mus. The authors discuss "nystagmogra­phy" in the last, nine-page chapter. Noactual recorded tracing of nystagmus orother ocular movements appears in thebook. Approximately one half of the ref­erences date from 1950 or earlier; cita­tions from the past decade are surprising­ly few.

The book may represent an accurateextension of the work of Frenzel, who wasmost active from 1925 to 1950, but it willnot prove very useful to contemporarystudents seeking a clear understanding ofthe vestibule-ocular system and its disor­ders, to ophthalmologists, or to modernclinical investigators in the field.

CARL ELLENBERGER, JR.