The tenth edition of this British textbook represents a reasonable effort to cover the broad expanse of contemporary hematology, but there are areas of checkered quality. For example, in the discussion of acute leukemias quadruple therapy is scarcely mentioned, and chloramphenicolinduced acute leukemia does not appear. In the section on idiopathic thrombocytopenic purpura (ITP) the statement is made, "If the patient has become exsanguinated, blood transfusion may be needed." (I have always admired British understatement, but this is a bit much.) After suggesting "platelet transfusion," "plugging the nose," and Russell Viper Venom in the management of ITP, Britton recommends "steroids" (no dose given), and with regard to splenectomy "The author favours waiting at least a year for the platelet count to recover spontaneously or with some help from occasional low dosage courses of prednisone." I suspect such a relaxed program would find little favor in this country.
In the discussion