Bishop, who has written some first-rate sf short stories, is a novelist of more ambition than control. Here he gives us weary, middle-aged Lucian Yeardance, shunted off to a nco-Aztec planetary backwater to become ""kommissar"" of a medical facility providing indifferent treatment for a despised community of ""muphormers""--victims of a mutilating leprous affliction. Yeardance's lonely crusade on behalf of the muphormers turns up increasing evidence of some mass psychosis, ultimately going back to the attitudes of the ""normal"" citizenry. Bishop can be seen straining mightily for motifs and image-patterns and great ethical generalizations; but, with all its awkwardness, this is a much fiercer and more arresting book than last year's And Strange at Ecbatan the Trees.