Backing up the pioneering medical researchers and experi menters are the phalanxes and cohorts of practising clinicians in district general hospitals and in general practice who may have to implement and apply any breakthroughs and advances in practical and realistic terms. This they cannot, and should not, be expected to do without careful consideration and analysis. It is essential, therefore, to have regular reviews of the growing points of medicine which are constructively critical as well as being enthusiastic and which can present the issues and implications clearly and fairly to clinicians. The Practical Clinical Medicine series is designed to provide such regular reviews on selected subjects. Each volume is under the charge of an invited editor who selects his team of 4--6 experts. Each contribution is an authoritative, detailed and referenced examination of his topic, is clearly presented in an understandable manner and is practical, relevant and applic able to everyday clinical practice. The series is intended as a means of communication between researchers and practising clinicians. It is dedicated to gener alists who provide primary health care in general practice and to generalists providing secondary medical care in district vii viii Series Editors' Foreword general hospitals. Both are involved in applying good general practical clinical medicine for their patients, but can only succeed in a climate of constant review and examination."

DDDDDDDDDDDDD Effective management logically follows accurate diagnosis. Such logic often is difficult to apply in practice. Absolute diagnostic accuracy may not be possible, particularly in the field of primary care, when management has to be on analysis of symptoms and on knowledge of the individual patient and family. This series follows that on Problems in Practice which was concerned more with diagnosis in the widest sense and this series deals more definitively with general care and specific treatment of symptoms and diseases. Good management must include knowledge of the nature, course and outcome of the conditions, as well as prominent clinical features and assess is on what to do best for the ment and investigations, but the emphasis patient. Family medical practitioners have particular difficulties and advantages in their work. Because they often work in professional isolation in the com munity and deal with relatively small numbers of near-normal patients their experience with the more serious and more rare conditions is restricted. They find it difficult to remain up-to-date with medical advances and even more difficult to decide on the suitability and application of new and rela tively untried methods compared with those that are 'old' and well proven. Their advantages are that because of long-term continuous care for their patients they have come to know them and their families well and are able to become familiar with the more common and less serious diseases of their communities."

Part one of the book presents the gastrointestinal problems that commonly face the general practitioner. Emphasis is placed on analysis of clinical data and how this may provoke the most profitable lines of investigation. Many of the investigation and treatment protocols are within the scope of general practice, but hospital management is also included. It was possible to deal with common oesophageal diseases under the heading of oeso phageal problems in Part 1. In contrast, it proved impossible to discuss adequately all of the common diseases affecting other organs of the digestive system under the problem headings. For this reason, a fuller ac count of many common alimentary diseases is provided in Part two. M. L.-5. K. G. D. W. 9 Series Foreword This series of books is designed to help general practitioners. So are other books. What is unusual in this instance is their collec tive authorship; they are written by specialists working at district general hospitals. The writers derive their own experi ence from a range of cases less highly selected than those on which textbooks are traditionally based. They are also in a good position to pick out topics which they see creating difficulties for the practitioners of their district, whose personal capacities are familiar to them; and to concentrate on contexts where mistakes are most likely to occur. They are all well-accustomed to working in consultation."