The fact that this is volume 3 indicates the continuity of the subject and provides the authors with a convenient viewpoint from which to survey the scene. More than three years have elapsed since the publication of the first two volumes, and the Introduction to the third volume must make particularly thoughtful reading for all those actively concerned with the application of computers to medical care. Volume three has been deliberately dedicated to practical applications of computers in clinical situations, but in spite of this, the editors feel that a definite answer to the question "Has the computer materially altered the treatment of disease" is still in abeyance. Nobody reading the chapters in this volume could doubt the sincerity and technical accomplishments of the authors. However, the cost of a versatile computer system is still high, both in terms of hardware and personnel back-up. For these reasons progress is only being made in a limited number of centres, and in terms of cost-effectiveness, this fact must be offset against the medical services of each country. Medicine is, in common with many disciplines, being steadily permeated by an increasing amount of technology. In practice this does not diminish the clinician's role, but enhances his powers. The availability of a computer in a medical establishment acts as a focal point for the interfacing of clinicians with staff from many disciplines, to the benefit of all. Since the raw materials for computer studies in medicine consist basically of human beings, it is incumbent upon those entrusted with computer facilities to work, as far as is reasonably practical, towards some degree of standardization of their efforts. This should ensure a continued expansion of computer techniques into other hospitals. Stacy and Waxman are doing a great deal to "spread the gospel".
Biochemical tests are providing an area for much needed automation, and there are two chapters concerned with the interfacing of a digital computer to an Autoanalyser system. One system is based on a Linc and is suitable for a hospital with up to 1000 beds. The other uses a satellite computer with an 8K, 1.6 microsecond, 18-bit core plus a 1-5 million word disk. This is in the hospital for handling on-line data, with the main computer in the medical school. It can handle all the information arising from Clinical Pathology, Pathology, Radiology, ECG, EEG, Medical Diagnosis and Pharmacy by storing them and having them ready for CRT display using three hours computer time per day. Other chapters deal with the setting up of a computer-based tumour registry and the development of a high-speed-sell sorting and identification system. A particularly interesting description is given in the latter chapter of the automatic identification of cancer ceils from vaginal swabs and washes. If routine cervical screening is to be introduced on a nation-wide basis,