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This book, edited by Dr. Skinner and the group at Johns Hopkins jointly with Dr. Belsey of Bristol, England, is a clearly written, concise monograph emphasizing the modern trend in management of gastroesophageal reflux and hiatal hernia. The chapters on function and pathology of reflux esophagitis, the material on diagnostic tests, represent a thorough coverage of the modern emphasis on reflux rather than the anatomical component of hiatal hernia. If anything, the pendulum has swung a bit too far to the exclusion of problems related to the incarceration of the viscus in the posterior mediastinum. The fact that an incarcerated hiatal hernia may cause symptoms varying from pressure symptoms to perforation in the posterior mediastinum may go unappreciated because of present day overemphasis on reflux as the primary cause of both symptoms and complications of hiatal hernia. On the other hand, as Dr. Skinner and his colleagues indicate, surgeons have